Magnolia Midlands Pain Management

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

062371 Issued in GA

Legal business name

MAGNOLIA MIDLANDS PAIN MANAGEMENT

Practice address

186 S. Macon St.
Jesup, GA 31545-1117

Phone

(912) 530-7516

Fax

(912) 530-7517

NPI assigned

Jun 22, 2009

Last updated

Nov 5, 2012By 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

Mrs. Mandy Burke

Title

Office Manager

Phone

(912) 530-7516

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1811124456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 S. MACON STREET",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451117",
            "telephone_number": "912-530-7516",
            "fax_number": "912-530-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 S. MACON ST.",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451117",
            "telephone_number": "912-530-7516",
            "fax_number": "912-530-7517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MIDLANDS PAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "MANDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-530-7516",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "062371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166390878A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lung Associates, PC
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• Gregory Alan Madray, DDS PC
• Sandra L Mager, M.D.
• Jennifer C. Mann-Mackey, LPC
• Mark Byron MD PC
• Shanekia Marsh, NP-C
• Kayla Mathie, FNP-C
• Shauna Mattingly, LCSW

• Pain Medicine (Anesthesiology) Physician in Jesup, GA
• Providers in Jesup, GA by specialty
• Pain Medicine (Anesthesiology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.