Atlanta Pain Rehabilitation Management, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

156887 Issued in GA

Legal business name

ATLANTA PAIN REHABILITATION MANAGEMENT, LLC

Doing business as

atlanta pain rehabilitation

Practice address

2950 Stone Hogan Rd
BLDG 3 Suite B
Atlanta, GA 30331-2837

Phone

(404) 228-2587

NPI assigned

Nov 19, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Jacob Koshy

Title

Manager

Phone

(404) 228-2587

Specialties & licenses 1

Addresses

Other names 1

• atlanta pain rehabilitation Doing business as

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1689918310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 STONE HOGAN ROAD CONN,",
            "address_2": "BLDG 3 SUITE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30331",
            "telephone_number": "404-228-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 STONE HOGAN RD",
            "address_2": "BLDG 3 SUITE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312837",
            "telephone_number": "404-228-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA PAIN REHABILITATION MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "KOSHY",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-228-2587",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "GA",
            "license": "156887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "atlanta pain rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Atlanta Pediatric Partners PC
• Atlanta Pediatric Surgery PC
• Atlanta Pelvic & Orthopedic Rehab Center, LLC

• Multi-Specialty Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.