NPIMap

Organization Active NPI

Synergy Pain and Rehabilitation

  • Specialist
  • Atlanta, GA
National Provider Identifier
1376580167
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
6956 Issued in GA
Legal business name
SYNERGY PAIN AND REHABILITATION
Practice address
1985 Howell Mill Rd NW
Ste. B
Atlanta, GA 30318-2566
Phone
(404) 355-1322
Fax
(404) 355-5404
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Vincent Bubolo, D.C.NPI 1518919026
Title
Owner
Phone
(404) 355-1322

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 6956 GA Primary

Addresses

Primary practice location

1985 Howell Mill Rd NW
Ste. B
Atlanta, GA 30318-2566

Mailing address

1985 Howell Mill Rd NW
Ste. B
Atlanta, GA 30318-2566
Phone (404) 355-1322

National Provider Directory

National Provider Directory

Locations

1985 Howell Mill Rd NW
Ste B
Atlanta, GA 30318
Phone (404) 355-1322

Practitioners & affiliated clinicians

Practitioners 6

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": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376580167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 HOWELL MILL RD NW",
            "address_2": "STE. B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182566",
            "telephone_number": "404-355-1322",
            "fax_number": "404-355-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 HOWELL MILL RD NW",
            "address_2": "STE. B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182566",
            "telephone_number": "404-355-1322",
            "fax_number": "404-355-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY PAIN AND REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUBOLO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-355-1322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "6956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.