Pain Treatment Centers of Georgia LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

PAIN TREATMENT CENTERS OF GEORGIA LLC

Practice address

303 Harris Industrial Blvd
Vidalia, GA 30474-8853

Phone

(912) 910-3777

Fax

(912) 292-0005

NPI assigned

Jun 15, 2026

Organization subpart

No

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

Authorized official

Name

Vadim Petrov-Kondratov, MDNPI 1891061040

Title

Director/Owner

Phone

(912) 910-3777

Specialties & licenses 1

Addresses

Tax ID family

Pain Treatment Centers of Georgia LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Pain Treatment Centers of Georgia LLC

  • Pain Medicine Physician
  • Swainsboro, GA
  • NPI 1568327211
  NPD tax ID
• Pain Treatment Centers of Georgia LLC

  • Clinic/Center
  • Savannah, GA
  • NPI 1619702792
  NPD tax ID

Practitioners 1

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

• Vadim Petrov-Kondratov, M.D.

  • Interventional Pain Medicine Physician
  • Hinesville, GA
  • NPI 1891061040
  NPD (past) Authorized official

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

{
    "created_epoch": "1781481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781481600000",
    "number": "1447185129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 W OGLETHORPE HWY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134415",
            "telephone_number": "912-910-3777",
            "fax_number": "912-292-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 HARRIS INDUSTRIAL BLVD",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748853",
            "telephone_number": "912-910-3777",
            "fax_number": "912-292-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN TREATMENT CENTERS OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-15",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "PETROV-KONDRATOV",
        "authorized_official_first_name": "VADIM",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "912-910-3777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Pain Medicine (Anesthesiology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.