Philip T. Slack, MD

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

035523 Issued in GA

Practice address

1315 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3822

Phone

(770) 219-6520

Fax

(770) 219-1016

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Specialty

AnesthesiologyAlso: Pain Management

Education

Emory University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Georgialina Physical Therapy Associates LLCGroup PAC ID 6002812401, 406 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
• Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041

Merit-based Incentive Payment System (MIPS)

Final score

87.83 of 100Reported as group

Quality

80.36

Promoting interoperability

100

Improvement activities

40

Cost

79.08

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pslack29394@nghs.gadirect.net

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.

• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212
  Medicare reassignment Care Compare group NPD
• Georgialina Physical Therapy Associates LLC

  dba Athletico Physical Therapy

  • Physical Therapist
  • Augusta, GA
  • NPI 1679286934
  Care Compare group
• Ambulatory Anesthesia of North Georgia, LLC

  • Anesthesiology Physician
  • Gainesville, GA
  • NPI 1497870562
  NPD (past)
• American Anesthesiology Associates of Georgia, LLC

  • Anesthesiology Physician
  • Stone Mountain, GA
  • NPI 1528068673
  NPD (past)
• Anesthesia Associates of Gainesville, LLC

  • Anesthesiology Physician
  • Gainesville, GA
  • NPI 1457456485
  NPD (past)
• Dekalb Anesthesia Associates, P a

  • Anesthesiology Physician
  • Decatur, GA
  • NPI 1528004538
  NPD (past)

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

• Northeast Georgia Medical Center Habersham LLC

  • General Acute Care Hospital
  • Demorest, GA
  • NPI 1740981430
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1639113095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 JESSE JEWELL PKWY NE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013822",
            "telephone_number": "770-219-6520",
            "fax_number": "770-219-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "PHILIP",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "035523",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "035523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000552824C",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pslack29394@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1315 Jesse Jewell Pkwy NE Ste 300",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Gail Skarda
• Skin Center of Georgia, PC (Georgia Skin Center)
• Cassidy May Skinner
• Jeffrey Francis Skorput, PT
• SKP ASC LLC
• Sleepmed, Inc
• Bridget Sloan
• Michelle Sloan, RNFA,BSN
• Slotwinski Eyecare Inc
• Jennifer G. Slotwinski, O.D.

• Pain Medicine (Anesthesiology) Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Pain Medicine (Anesthesiology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.