Pain & Spine Physicians Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PAIN & SPINE PHYSICIANS SURGERY CENTER LLC

Practice address

3333 Old Milton Pkwy Ste 430
Alpharetta, GA 30005-4437

Phone

(770) 391-3979

Fax

(770) 391-0020

NPI assigned

Jun 16, 2018

Organization subpart

No

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

Authorized official

Name

Virginia Minicozzi

Title

Practice Manager

Phone

(770) 391-3979

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Pain Spine Physicians Surgery Center LLCCCN 11C0001495

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Pain Physicians Anesthesia, LLC

  • Anesthesiology Physician
  • Alpharetta, GA
  • NPI 1194287763

  Member Of

  NPD member

Practitioners 3

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

• Mohammed Shazad Wada, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Alpharetta, GA
  • NPI 1477785186
  NPD
• Monica E Burrell, CRNA

  • Certified Registered Nurse Anesthetist
  • Alpharetta, GA
  • NPI 1184978041
  NPD (past)
• Kenneth Howard Joel, MD

  • Pain Medicine (Anesthesiology) Physician
  • Alpharetta, GA
  • NPI 1346236411
  NPD (past)

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

{
    "created_epoch": "1529107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1477047199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 OLD MILTON PKWY STE 430",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054437",
            "telephone_number": "770-391-3979",
            "fax_number": "770-391-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 OLD MILTON PKWY STE 430",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054437",
            "telephone_number": "770-391-3979",
            "fax_number": "770-391-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN & SPINE PHYSICIANS SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-16",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MINICOZZI",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "770-391-3979"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Dawn Pack, AU.D.
• Harlee Ruth Paetzold, CCC-SLP
• Roxanne Page
• Pai Dental, P.C.
• Dorothy Paige, LPC
• Pain & Wellness Center of North Fulton
• Pain Physicians Anesthesia, LLC
• Pain Physicians of America, LLC
• Pain Physicians of Atlanta LLC
• Carleton A Palmer, PH.D.

• Ambulatory Surgical Clinic/Center in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.

Verify at the official NPI Registry.