Organization Active NPI

Comprehensive Spine & Pain LLC

  • Pain Medicine Physician
  • Villa Rica, GA
National Provider Identifier
1376050971
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
COMPREHENSIVE SPINE & PAIN LLC
Practice address
403 Permian Way Ste D
Villa Rica, GA 30180-3226
Phone
(770) 627-7246
Fax
(855) 332-9452
NPI assigned
Jan 4, 2018
Last updated
Jan 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Authorized official

Name
Vinaya K. PuppalaNPI 1548426810
Title
MD/Owner
Phone
(770) 627-7246

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 Physician 208VP0000X Primary

Addresses

Primary practice location

403 Permian Way Ste D
Villa Rica, GA 30180-3226

Mailing address

PO Box 20476
Belfast, ME 04915-4099
Phone (770) 627-7246

National Provider Directory

National Provider Directory

Locations

5055 Roswell Rd
Ste 350a
Atlanta, GA 30342

1533 Pleasant Hill Rd
Duluth, GA 30096
Phone (770) 931-3434

2550 Windy Hill Rd SE
Ste 310
Marietta, GA 30067

34 Upper Riverdale Rd SE
Ste 203
Riverdale, GA 30274
Phone (770) 907-7973

403 Permian Way
Ste D
Villa Rica, GA 30180
Phone (470) 827-3648

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515024000000",
    "number": "1376050971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20476",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154099",
            "telephone_number": "770-627-7246",
            "fax_number": "855-332-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 PERMIAN WAY STE D",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301803226",
            "telephone_number": "770-627-7246",
            "fax_number": "855-332-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE SPINE & PAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A",
        "authorized_official_last_name": "PUPPALA",
        "authorized_official_first_name": "VINAYA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "770-627-7246"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.