NPIMap

Organization Active NPI

Peachtree Spine & Pain Physicians, Inc

  • Physical Medicine & Rehabilitation Physician
  • Atlanta, GA
National Provider Identifier
1700899754
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
PEACHTREE SPINE & PAIN PHYSICIANS, INC
Practice address
5555 Peachtree Dunwoody Rd NE
Suite 201
Atlanta, GA 30342-1703
Phone
(404) 843-3323
Fax
(404) 574-5944
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
Dr. Jeffrey S Grossman, M.D.
Title
President
Phone
(404) 843-3323

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X

Addresses

Primary practice location

5555 Peachtree Dunwoody Rd NE
Suite 201
Atlanta, GA 30342-1703

Mailing address

5555 Peachtree Dunwoody Rd Ste G65
Atlanta, GA 30342-1710
Phone (404) 843-3323

Other names 1

  • Peachtree Spine Physicians, Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000458 GA Part B Supplier - Clinic/Group Practice 3375436595 Receives reassigned benefits from 9 practitioners
Practice locations: Decatur, GA; Suwanee, GA; Norcross, GA; McDonough, GA; Marietta, GA; Lithonia, GA; Douglasville, GA; Atlanta, GA

National Provider Directory

National Provider Directory

Locations

785 Virginia Ave
Atlanta, GA 30354

5555 Peachtree Blvd
Atlanta, GA 30341

4830 Peachtree Industrial Blvd
Berkeley Lake, GA 30071

2785 Lawrenceville Hwy
Ste 100
Decatur, GA 30033
Phone (404) 292-1144

160 Clairemont Ave
Ste 150
Decatur, GA 30030
Phone (404) 824-1755

320 N Jeff Davis Dr
Fayetteville, GA 30214

1016 Thompson Bridge Rd
Gainesville, GA 30501
Phone (678) 450-1222

771 Virginia Ave
Hapeville, GA 30354

8225 Mall Pkwy
Ste 250
Lithonia, GA 30038
Phone (404) 297-1818

2155 Post Oak Tritt Rd
Ste 410
Marietta, GA 30062

531 Roselane St NW
Ste 530
Marietta, GA 30060

1770 Indian Trail Rd
Norcross, GA 30093
Phone (470) 807-9131

1770 Indian Trail Lilburn Rd
Ste 160
Norcross, GA 30093

1770 Indian Trail Lilburn Rd
Ste 410
Norcross, GA 30093

5555 Peachtree Dunwoody Rd
Ste G85
Sandy Springs, GA 30342

4225 Johns CRK Pkwy Ste C
Suwanee, GA 30024

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1700899754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD STE G65",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421710",
            "telephone_number": "404-843-3323",
            "fax_number": "404-574-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-843-3323",
            "fax_number": "404-574-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE SPINE & PAIN PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-843-3323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree Spine Physicians, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peachtree Spine Physicians, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.