Organization Active NPI

Atl Pain Management Consulting Group LLC

Doing business as ATL Pain Institute

  • Physical Medicine & Rehabilitation Physician
  • Atlanta, GA
National Provider Identifier
1447539697
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ATL PAIN MANAGEMENT CONSULTING GROUP LLC
Doing business as
ATL Pain Institute
Practice address
4535 Winters Chapel Rd
Suite B
Atlanta, GA 30360-2705
Phone
(678) 580-1862
NPI assigned
Aug 5, 2011
Last updated
Dec 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Matthew DiduroNPI 1376514638
Title
Owner
Phone
(678) 580-1862

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

4535 Winters Chapel Rd
Suite B
Atlanta, GA 30360-2705

Mailing address

4535 Winters Chapel Rd
Suite B
Atlanta, GA 30360-2705
Phone (678) 580-1862

Other names 1

  • ATL Pain Institute Doing business as

National Provider Directory

National Provider Directory

Locations

4535 Winters Chapel Rd
#A
Doraville, GA 30360
Phone (678) 580-1862

4535 Winters Chapel Rd
#B
Doraville, GA 30360
Phone (678) 580-1862

Practitioners & affiliated clinicians

Practitioners 1

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": "1312502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1447539697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 WINTERS CHAPEL RD",
            "address_2": "SUITE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303602705",
            "telephone_number": "678-580-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 WINTERS CHAPEL RD",
            "address_2": "SUITE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303602705",
            "telephone_number": "678-580-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATL PAIN MANAGEMENT CONSULTING GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-05",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "DIDURO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-580-1862"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATL Pain Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 18, 2012; 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.