Interventional Spine and Pain Mangement Center, PC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

INTERVENTIONAL SPINE AND PAIN MANGEMENT CENTER, PC

Practice address

134 Riverstone Ter
Suite 101
Canton, GA 30114-1706

Phone

(770) 929-9033

Fax

(770) 929-9092

NPI assigned

Dec 29, 2015

Organization subpart

Yes

Parent organization

INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PCAs reported in NPPES

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

Authorized official

Name

Victoria Beck

Title

Cfo

Phone

(404) 403-8310

Specialties & licenses 1

Addresses

Other names 1

• Alliance Spine and Pain Centers Doing business as

Part of

Ispm ASC at Camp Creek LLC

Locations

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1720443252",
    "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",
            "telephone_number": "770-929-9033",
            "fax_number": "770-929-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 RIVERSTONE TER",
            "address_2": "SUITE 101",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301141706",
            "telephone_number": "770-929-9033",
            "fax_number": "770-929-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE AND PAIN MANGEMENT CENTER, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC",
        "enumeration_date": "2015-12-29",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "404-403-8310"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alliance Spine and Pain Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alliance Spine and Pain Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Interventional Pain Medicine Physician in Canton, GA
• Providers in Canton, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.