Interventional Pain Institute LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

INTERVENTIONAL PAIN INSTITUTE LLC

Practice address

3200 Gillionville Rd
Albany, GA 31721-2815

Phone

(229) 405-2470

Fax

(229) 405-2473

NPI assigned

Mar 30, 2021

Last updated

Oct 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Willie Michael Fussell, DONPI 1740377787

Title

Physician

Phone

(229) 405-2470

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Interventional Pain Institute LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Interventional Pain Institute LLC

  • Interventional Pain Medicine Physician
  • Albany, GA
  • NPI 1568003481
  NPD tax ID
• Regional Health Group Inc

  dba Musculoskeletal Associates

  • Orthopaedic Surgery Physician
  • Albany, GA
  • NPI 1346210705
  NPD tax ID
• Regional Health Group Inc

  dba Musculoskeletal Associates

  • Interventional Pain Medicine Physician
  • Albany, GA
  • NPI 1952576571
  NPD tax ID

Locations

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.

• Willie Michael Fussell, D.O.

  • Interventional Pain Medicine Physician
  • Albany, GA
  • NPI 1740377787
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1508444837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 OLD DAWSON RD STE 2, #245",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317071413",
            "telephone_number": "229-405-2470",
            "fax_number": "229-405-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 GILLIONVILLE RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317212815",
            "telephone_number": "229-405-2470",
            "fax_number": "229-405-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL PAIN INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-30",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "FUSSELL",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "229-405-2470",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA57620",
            "identifier": "GA57620",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fuss5@hotmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 Gillionville Rd",
            "city": "Albany",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317212815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Albany, GA
• Providers in Albany, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.