NPIMap

Organization Active NPI

The Interventional Spine and Pain Management Center PC

  • Interventional Pain Medicine Physician
  • Marietta, GA
National Provider Identifier
1649626375
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
THE INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER PC
Practice address
400 Tower Rd NE
Suite 350
Marietta, GA 30060-9411
Phone
(770) 929-9033
Fax
(770) 929-9092
NPI assigned
May 12, 2016
Last updated
Aug 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Authorized official

Name
Erin Sherrod
Title
Manager
Phone
(404) 920-4950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X GA Primary

Addresses

Primary practice location

400 Tower Rd NE
Suite 350
Marietta, GA 30060-9411

Mailing address

3390 Peachtree Rd NE
Suite 1500
Atlanta, GA 30326-1157
Phone (404) 920-4950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170328001048 GA DME Supplier - Physician - Interventional Pain Management 2769483031 Practice locations: Marietta, GA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2174194Interventional Spine and Pain Management Ctr, PC400 Tower Road, Suite 350, Marietta, GA 30060Certificate of waiverOct 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Interventional Spine Pain10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1649626375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 PEACHTREE RD NE",
            "address_2": "SUITE 1500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261157",
            "telephone_number": "404-920-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TOWER RD NE",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609411",
            "telephone_number": "770-929-9033",
            "fax_number": "770-929-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-12",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "SHERROD",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-920-4950"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.