Organization Active NPI

Interventional Spine and Pain Management Center, PC

  • Interventional Pain Medicine Physician
  • Atlanta, GA
National Provider Identifier
1649939976
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC
Practice address
1100 Lake Hearn Dr Ste 330
Atlanta, GA 30342-1523
Phone
(404) 920-4950
NPI assigned
Dec 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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) 920-4972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

1100 Lake Hearn Dr Ste 330
Atlanta, GA 30342-1523

Mailing address

3390 Peachtree Rd NE Ste 1500
Atlanta, GA 30326-2822

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
11D2265470Interventional Spine and Pain Management, PC1100 Lake Hearn Drive, Suite 335, Atlanta, GA 30342Certificate of waiverJul 27, 2028

National Provider Directory

National Provider Directory

Locations

1100 Lake Hearn Dr
Ste 330
Sandy Springs, GA 30342

NPI Registry JSON

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1649939976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 PEACHTREE RD NE STE 1500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303262822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE HEARN DR STE 330",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421523",
            "telephone_number": "404-920-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "SHERROD",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-920-4972"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.