Johns Creek Center for Pain and Spine

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

JOHNS CREEK CENTER FOR PAIN AND SPINE

Practice address

6300 Hospital Pkwy
Suite 425
Johns Creek, GA 30097-1828

Phone

(770) 771-6580

NPI assigned

Apr 19, 2017

Organization subpart

No

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

Authorized official

Name

Lindsey Ann Mathes

Title

Coo

Phone

(770) 771-6582

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 110239

Legal name

JOHNS CREEK CENTER FOR PAIN AND SPINE

Certification status

Terminated Voluntary: merger or closure, Apr 19, 2020

Provider type (POS)

Hospital – Short-term

Participating since

Apr 15, 2020

Last certification

Apr 15, 2020

Beds

1

Ownership / control type

Private (for profit)

Facility address

6300 Hospital Pkwy, Ste 425
Johns Creek, GA 30097

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Pain Care LLC

  • Anesthesiology Physician
  • Stockbridge, GA
  • NPI 1265607626

  Member Of

  NPD member

Locations

Practitioners 1

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

• Vincent Galan, MD

  • Pain Medicine Physician
  • Stockbridge, GA
  • NPI 1831180983
  NPD (past)

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503619200000",
    "number": "1801320510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 ROCK QUARRY RD",
            "address_2": "SUITE 202",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815029",
            "telephone_number": "770-771-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 HOSPITAL PKWY",
            "address_2": "SUITE 425",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971828",
            "telephone_number": "770-771-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS CREEK CENTER FOR PAIN AND SPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-08-25",
        "status": "A",
        "authorized_official_last_name": "MATHES",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-771-6582"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Y Jeong
• JHL Imaging Services LLC
• Lanlan Jiang
• Nida Suleman Jiwani, DO
• JL Health Center LLC
• Johns Creek Dental Excellence, P.C.
• Johns Creek Dentistry, P.C.
• Johns Creek Dermatology and Family Medicine, P.C.
• Johns Creek House Call Providers LLC
• Johns Creek Neonatology

• Ambulatory Surgical Clinic/Center in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.