Georgia Interventional Pain - F, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GEORGIA INTERVENTIONAL PAIN - F, LLC

Practice address

1357 Hembree Rd Ste 230
Roswell, GA 30076-5725

Phone

(770) 962-3642

Fax

(770) 962-3643

NPI assigned

Dec 13, 2019

Organization subpart

No

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

Authorized official

Name

Amit Patel, MDNPI 1386834117

Title

Chief Executive Officer

Phone

(770) 962-3642

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amit Patel, MD

  • Anesthesiology Physician
  • Lawrenceville, GA
  • NPI 1386834117
  NPD (past) Authorized official
• Gabriel Marrero, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Lawrenceville, GA
  • NPI 1871789214
  NPD (past)

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1700424322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 PHILIP BLVD STE 140",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468768",
            "telephone_number": "770-962-3642",
            "fax_number": "770-962-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 HEMBREE RD STE 230",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765725",
            "telephone_number": "770-962-3642",
            "fax_number": "770-962-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA INTERVENTIONAL PAIN - F, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "AMIT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "770-962-3642",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Roswell, GA
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.