NPIMap

Organization Active NPI

Eastside Spine & Pain Center

  • Rehabilitation Chiropractor
  • Snellville, GA
National Provider Identifier
1649509605
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
CHIR002563 Issued in GA
Legal business name
EASTSIDE SPINE & PAIN CENTER
Practice address
1580 Tree LN
Snellville, GA 30078-2207
Phone
(770) 979-2225
Fax
(770) 979-8348
NPI assigned
Dec 21, 2009
Last updated
Dec 21, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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

Authorized official

Name
Dr. Marie N. Soracco, D.C.NPI 1306912027
Title
Clinic Director
Phone
(770) 979-2225

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X CHIR002563 GA Primary

Addresses

Primary practice location

1580 Tree LN
Snellville, GA 30078-2207

Mailing address

PO Box 325
Snellville, GA 30078-0325
Phone (770) 979-2225

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261353600000",
    "number": "1649509605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300780325",
            "telephone_number": "770-979-2225",
            "fax_number": "770-979-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 TREE LN",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782207",
            "telephone_number": "770-979-2225",
            "fax_number": "770-979-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE SPINE & PAIN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-21",
        "last_updated": "2009-12-21",
        "status": "A",
        "authorized_official_last_name": "SORACCO",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "770-979-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR002563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.