NPIMap

Organization Active NPI

Pain Treatment Centers of Georgia LLC

  • Pain Medicine Physician
  • Swainsboro, GA
National Provider Identifier
1568327211
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
PAIN TREATMENT CENTERS OF GEORGIA LLC
Practice address
303 S Main St
Swainsboro, GA 30401-3613
Phone
(912) 910-3777
Fax
(912) 292-0005
NPI assigned
Dec 16, 2025
Last updated
Dec 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Vadim Petrov-KondratovNPI 1891061040
Title
Owner/MD
Phone
(912) 910-3777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

303 S Main St
Swainsboro, GA 30401-3613

Mailing address

604 W Oglethorpe Hwy
Hinesville, GA 31313-4415
Phone (912) 910-3777

National Provider Directory

National Provider Directory
Tax ID family
Pain Treatment Centers of Georgia LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1765843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1568327211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 W OGLETHORPE HWY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134415",
            "telephone_number": "912-910-3777",
            "fax_number": "912-292-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S MAIN ST",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013613",
            "telephone_number": "912-910-3777",
            "fax_number": "912-292-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN TREATMENT CENTERS OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "PETROV-KONDRATOV",
        "authorized_official_first_name": "VADIM",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "912-910-3777"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swainsboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.