NPIMap

Organization Active NPI

Southern Injury Specialists LLC

  • Pain Medicine Physician
  • Gainesville, GA
National Provider Identifier
1508648445
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
SOUTHERN INJURY SPECIALISTS LLC
Doing business as
Southern Injury Specialists LLC
Practice address
601 Broad St SE Ste a
Gainesville, GA 30501-3718
Phone
(678) 971-4167
Fax
(833) 989-2501
NPI assigned
Oct 16, 2023
Last updated
Oct 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Authorized official

Name
Ankur Patel, DONPI 1780971994
Title
Owner
Phone
(205) 422-5189

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
Pain Medicine Physician 208VP0000X NU Primary

Addresses

Primary practice location

601 Broad St SE Ste a
Gainesville, GA 30501-3718

Mailing address

601 Broad St SE Ste a
Gainesville, GA 30501-3718
Phone (678) 971-4167

Other names 1

  • Southern Injury Specialists LLC Doing business as

National Provider Directory

National Provider Directory

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": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1508648445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BROAD ST SE STE A",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013718",
            "telephone_number": "678-971-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROAD ST SE STE A",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013718",
            "telephone_number": "678-971-4167",
            "fax_number": "833-989-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN INJURY SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ANKUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-422-5189",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Injury Specialists LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.