Individual provider Active NPI

Tom Ju, MD

  • Interventional Pain Medicine Physician
  • Roswell, GA
National Provider Identifier
1508201393
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
89892 Issued in GA
Practice address
960 Holcomb Bridge Rd Ste 150
Roswell, GA 30076-1963
Phone
(770) 988-7246
Fax
(770) 988-7247
NPI assigned
May 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 201801276 NC
Interventional Pain Medicine Physician 208VP0014X 89892 GA Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 4301103471 MI
Pain Medicine (Anesthesiology) Physician 207LP2900X MD52148 SC

Addresses

Primary practice location

960 Holcomb Bridge Rd Ste 150
Roswell, GA 30076-1963

Mailing address

960 Holcomb Bridge Rd Ste 150
Roswell, GA 30076-1963
Phone (770) 988-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180919004055 NC Practitioner - Interventional Pain Management 5092022582 Reassigns benefits to 1 organization
I20220510000288 GA Practitioner - Pain Management 5092022582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
University of Texas Southwestern Medical School at Dallas, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Align Spine and Pain Institute LLCGroup PAC ID 6709270200, 2 clinicians

Practice addresses (Care Compare)

3400 McClure Bridge Rd
Suite a
Duluth, GA 30096-6675
Phone (770) 988-7246

960 Holcomb Bridge Rd
Suite 150
Roswell, GA 30076-1963

Hospital & facility affiliations

  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
201801276NCMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Center PLLC Pain Medicine CurrentSince Oct 14, 2019 Accepting new patients
Interventional Pain Center, PLLC Pain Medicine CurrentSince Oct 14, 2019 Accepting new patients
Align Spine and Pain Institute LLC Pain Medicine CurrentSince Aug 1, 2021 Accepting new patients

Locations

3400 McClure Bridge Rd
Bldg A
Duluth, GA 30096
Phone (678) 404-1140

960 Holcomb Bridge Rd
Ste 150
Roswell, GA 30076
Phone (770) 988-7246

251 Keisler Dr
Ste 101
Cary, NC 27518
Phone (919) 803-0813

2153 Valleygate Dr
Ste 102
Fayetteville, NC 28304
Phone (910) 321-7246

2080 W Arlington Blvd
Ste A
Greenville, NC 27834
Phone (252) 439-0065

451 Ruin Creek Rd
Ste 103
Henderson, NC 27536
Phone (252) 438-3186

4320 Fayetteville Rd
Ste A
Lumberton, NC 28358
Phone (910) 738-2330

517 NC Highway 210 N
#B
Spring Lake, NC 28390
Phone (910) 436-0777

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJJGCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/EJJGCD/Endpoint/EJJGCD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1508201393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 HOLCOMB BRIDGE RD STE 150",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761963",
            "telephone_number": "770-988-7246",
            "fax_number": "770-988-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 HOLCOMB BRIDGE RD STE 150",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761963",
            "telephone_number": "770-988-7246",
            "fax_number": "770-988-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JU",
        "first_name": "TOM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NC",
            "license": "201801276",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "89892",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "4301103471",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "SC",
            "license": "MD52148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.