Organization Active NPI

Interventional Spine and Pain Management Center, PC

  • Interventional Pain Medicine Physician
  • Carrollton, GA
National Provider Identifier
1669831327
Registry record updated Nov 8, 2023
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
812 S Park St
Suite 5B
Carrollton, GA 30117-4412
Phone
(770) 929-9033
NPI assigned
Feb 23, 2016
Last updated
Nov 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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 NU Primary

Addresses

Primary practice location

812 S Park St
Suite 5B
Carrollton, GA 30117-4412

Mailing address

3390 Peachtree Rd NE
Suite 1500
Atlanta, GA 30326-1157

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
11D2308495Interventional Spine and Pain812 South Park Street, Suite 5a, Carrollton, GA 30117Certificate of waiverJul 29, 2028

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1669831327",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S PARK ST",
            "address_2": "SUITE 5B",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174412",
            "telephone_number": "770-929-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-23",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.