Jefferson Pain Clinic Inc

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

032558 Issued in GA

Legal business name

JEFFERSON PAIN CLINIC INC

Practice address

1351 Washington St
Jefferson, GA 30549-2879

Phone

(706) 387-0027

Fax

(706) 387-0073

NPI assigned

Feb 27, 2008

Last updated

Feb 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ahmad Ghadamyari

Title

President

Phone

(706) 387-0027

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jackson L Gates, M.D.

  • General Practice Physician
  • Conyers, GA
  • NPI 1962418400
  NPD (past)

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1710156393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 680904",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300680016",
            "telephone_number": "706-387-0027",
            "fax_number": "706-387-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 WASHINGTON ST",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305492879",
            "telephone_number": "706-387-0027",
            "fax_number": "706-387-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON PAIN CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "GHADAMYARI",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-387-0027",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "032558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jyotir Jani, M.D.
• Mary Grace Jaques, M.ED., CCC-SLP
• Jefferson City Schools
• Jefferson Counseling, LLC
• Jefferson Drug Company, Inc.
• Jefferson Pediatrics, Inc.
• Jefferson Psychiatric Services, LLC
• Erin Melissa Jones, OD
• Sierra Justice
• K and C Pharmacies Inc (Jefferson Drugs)

• Pain Medicine Physician in Jefferson, GA
• Providers in Jefferson, GA by specialty
• Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.