Organization Active NPI

Georgia Spine & Neurosurgery Center LLC

  • Neurological Surgery Physician
  • Decatur, GA
National Provider Identifier
1760684609
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
51201 Issued in GA
Legal business name
GEORGIA SPINE & NEUROSURGERY CENTER LLC
Practice address
2675 N Decatur Rd
Suite 110
Decatur, GA 30033-6131
Phone
(404) 299-3338
Fax
(404) 299-3315
NPI assigned
Jun 4, 2007
Last updated
Feb 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Authorized official

Name
Kaveh Khajavi, MDNPI 1487610275
Title
Owner
Phone
(404) 299-3338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 51201 GA Primary
Customized Equipment (DME) 332BC3200X 51201 GA

Addresses

Primary practice location

2675 N Decatur Rd
Suite 110
Decatur, GA 30033-6131

Mailing address

2675 N Decatur Rd
Suite 110
Decatur, GA 30033-6131
Phone (404) 299-3338

National Provider Directory

National Provider Directory

Locations

2001 Peachtree Rd NE
Ste 550
Atlanta, GA 30309
Phone (404) 299-3338

2675 N Decatur Rd
Ste 110
Decatur, GA 30033
Phone (404) 501-5368

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1760684609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 N DECATUR RD",
            "address_2": "SUITE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336131",
            "telephone_number": "404-299-3338",
            "fax_number": "404-299-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 N DECATUR RD",
            "address_2": "SUITE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336131",
            "telephone_number": "404-299-3338",
            "fax_number": "404-299-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA SPINE & NEUROSURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "KHAJAVI",
        "authorized_official_first_name": "KAVEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-299-3338",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "51201",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": "51201",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.