Organization Active NPI

Georgia Pain and Spine Institute, PC

  • Pain Medicine (Anesthesiology) Physician
  • Decatur, GA
National Provider Identifier
1336792019
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
GEORGIA PAIN AND SPINE INSTITUTE, PC
Practice address
2784 N Decatur Rd Ste 120
Decatur, GA 30033-5993
Phone
(678) 383-7246
Fax
(404) 228-3222
NPI assigned
Jul 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Michael Webb, MDNPI 1649432329
Title
Physician
Phone
(678) 383-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

2784 N Decatur Rd Ste 120
Decatur, GA 30033-5993

Mailing address

2784 N Decatur Rd Ste 120
Decatur, GA 30033-5993
Phone (678) 383-7246

Other practice location 1

1522 Rock Quarry Rd
Stockbridge, GA 30281-7386
Phone (678) 383-7246

Other identifiers 2

IdentifierTypeStateIssuer
67179OtherGAGA LICENSE
1649432329OtherGANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191020000010 GA Part B Supplier - Clinic/Group Practice 0446581607 Receives reassigned benefits from 1 practitioner
Practice locations: Decatur, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2172432Georgia Pain and Spine Institute, PC2784 N Decatur Road, Suite 120, Decatur, GA 30033Certificate of waiverFeb 29, 2028

National Provider Directory

National Provider Directory

Locations

1522 Rock Quarry Rd
Stockbridge, GA 30281
Phone (770) 506-4466

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GBDDDD
  • FHIR API: https://api.platform.athenahealth.com/20755/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1336792019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2784 N DECATUR RD STE 120",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335993",
            "telephone_number": "678-383-7246",
            "fax_number": "404-228-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2784 N DECATUR RD STE 120",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335993",
            "telephone_number": "678-383-7246",
            "fax_number": "404-228-3222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1522 Rock Quarry Rd",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302817386",
            "country_code": "US",
            "telephone_number": "678-383-7246",
            "fax_number": "404-228-3222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEORGIA PAIN AND SPINE INSTITUTE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-22",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "678-383-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "67179",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1649432329",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.