Active NPI
Center for Spine Interventions, PC
- Interventional Pain Medicine Physician
- Dallas, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- Legal business name
- CENTER FOR SPINE INTERVENTIONS, PC
- Practice address
- 2713 Charles Hardy Pkwy Ste 222
Dallas, GA 30157-9470 - Phone
- (678) 813-2741
- Fax
- (678) 813-2740
- NPI assigned
- Aug 21, 2012
- Last updated
- Aug 7, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Janice Raya
- Title
- Office Manager
- Phone
- (678) 813-2741
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Pain Medicine Physician | 208VP0014X | NU | Primary |
Addresses
Primary practice location
2713 Charles Hardy Pkwy Ste 222
Dallas, GA 30157-9470
Mailing address
2713 Charles Hardy Pkwy Ste 212
Dallas, GA 30157-9445
Phone (678) 813-2741
Other practice location 1
4450 Calibre Xing NW Ste 1118
Acworth, GA 30101-4104
Phone (678) 813-2741
Other practice location 2
4586 Timber Ridge Dr Ste 140
Douglasville, GA 30135-7513
Phone (678) 813-2741
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2147640 | Center for Spine Interventions Asc2, LLC | Certificate of waiver | Apr 23, 2028 |
National Provider Directory
National Provider DirectoryLocations
4450 Calibre Xing NW
Ste 1118
Acworth, GA 30101
Phone 6788132741103
2713 Charles Hardy Pkwy
Dallas, GA 30157
2713 Charles Hardy Pkwy
Ste 222
Dallas, GA 30157
Phone 6788132741103
Practitioners & affiliated clinicians
Practitioners 5
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.
-
- Pain Medicine Physician
- Dallas, GA
- NPI 1528055027
Physical Medicine & Rehabilitation
-
- Pain Medicine Physician
- Dallas, GA
- NPI 1316122922
-
- Anesthesiology Physician
- Marietta, GA
- NPI 1184240137
-
- Anesthesiology Physician
- Stockbridge, GA
- NPI 1255516183
-
- Family Nurse Practitioner
- Douglasville, GA
- NPI 1487433975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345507200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1565136000000",
"number": "1437407525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2713 CHARLES HARDY PKWY STE 212",
"city": "DALLAS",
"state": "GA",
"postal_code": "301579445",
"telephone_number": "678-813-2741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2713 CHARLES HARDY PKWY STE 222",
"city": "DALLAS",
"state": "GA",
"postal_code": "301579470",
"telephone_number": "678-813-2741",
"fax_number": "678-813-2740"
}
],
"practiceLocations": [
{
"address_1": "4450 Calibre Xing NW Ste 1118",
"address_purpose": "LOCATION",
"city": "Acworth",
"state": "GA",
"postal_code": "301014104",
"country_code": "US",
"telephone_number": "678-813-2741",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4586 Timber Ridge Dr Ste 140",
"address_purpose": "LOCATION",
"city": "Douglasville",
"state": "GA",
"postal_code": "301357513",
"country_code": "US",
"telephone_number": "678-813-2741",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CENTER FOR SPINE INTERVENTIONS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2012-08-21",
"last_updated": "2019-08-07",
"status": "A",
"authorized_official_last_name": "RAYA",
"authorized_official_first_name": "JANICE",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "678-813-2741"
},
"taxonomies": [
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.