South Atlanta Neurology & Pain Clinic, PC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

SOUTH ATLANTA NEUROLOGY & PAIN CLINIC, PC

Practice address

1040 Eagles Landing Pkwy
Ste 102
Stockbridge, GA 30281-9073

Phone

(770) 507-7359

Fax

(770) 507-8390

NPI assigned

Jun 26, 2008

Last updated

Jan 19, 2011By 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

Dr. Brice Byung-Il Choi, M.D.NPI 1174554455

Title

Owner/President

Phone

(770) 507-7359

Specialties & licenses 8

Addresses

Other identifiers 2

Other names 1

• OPEN MRI OF SANPC Other name

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Locations

Practitioners 2

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.

• Brice Choi, M.D

  • Specialist
  • Stockbridge, GA
  • NPI 1174554455
  Medicare reassignment NPD Authorized official
• Minna Choi, MD

  • Neurology Physician
  • Stockbridge, GA
  • NPI 1245720507
  Medicare reassignment NPD

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1639331150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1198",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302146198",
            "telephone_number": "770-507-7359",
            "fax_number": "770-507-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 EAGLES LANDING PKWY",
            "address_2": "STE 102",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819073",
            "telephone_number": "770-507-7359",
            "fax_number": "770-507-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ATLANTA NEUROLOGY & PAIN CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "BRICE",
        "authorized_official_middle_name": "BYUNG-IL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "770-507-7359",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "044899",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000783989F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1174554455",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OPEN MRI OF SANPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dayoung Song, DMD MS
• Sandra Ivelisse Sosa-Carlin, ED.D, NCC, LMHC, LPC
• Ashley Marie Soto
• Soul Solutions Therapeutic Services, LLC
• South Atlanta Ambulatory Surgical Center, LLC
• South Atlanta Neurosurgery
• South Atlanta Vascular Institute, LLC
• South Horizon Healthcare LLC
• South Metro Bone & Joint PC
• South Metro Rehab and Sports Medicine, LLC

• Neurology Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Neurology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.