SJ&J Spine and Pain Group

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

058527 Issued in GA

Legal business name

SJ&J SPINE AND PAIN GROUP

Practice address

5959 Highway 53 W
Suite 100B
Dawsonville, GA 30534

Phone

(678) 697-0199

NPI assigned

Nov 4, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Sallu Mohamed Jabati, MD

Title

Director/Physician

Phone

(678) 697-0199

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.

• Ekop S Udofia, PT, DPT

  • Physical Therapist
  • Chandler, AZ
  • NPI 1376848291
  NPD (past)

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257638400000",
    "number": "1801123302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 HIGHWAY 53 W",
            "address_2": "SUITE 100B",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "30534",
            "telephone_number": "678-697-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 HIGHWAY 53 W",
            "address_2": "SUITE 100B",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "30534",
            "telephone_number": "678-697-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJ&J SPINE AND PAIN GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2009-11-08",
        "status": "A",
        "authorized_official_last_name": "JABATI",
        "authorized_official_first_name": "SALLU",
        "authorized_official_middle_name": "MOHAMED",
        "authorized_official_title_or_position": "DIRECTOR/PHYSICIAN",
        "authorized_official_telephone_number": "678-697-0199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "058527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammed-Abdul Qadeer Siddiqui, M.D.
• Glenda Diane Simpson
• Katelynn Simpson
• Linda Simpson
• Elizabeth McKenzie Sipple, FNP-C
• Madalyn Slaton
• Traci Slaughter, FNP/C
• Kelli Smilie, PNP-PC
• Billy Cole Smith, PT, DPT
• Jerry Smith

• Interventional Pain Medicine Physician in Dawsonville, GA
• Providers in Dawsonville, 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 Nov 8, 2009; 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.