NPIMap

Organization Active NPI

Interventional Spine and Pain Management Center, PC

Doing business as Alliance Spine and Pain Centers

  • Interventional Pain Medicine Physician
  • Dacula, GA
National Provider Identifier
1861077315
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC
Doing business as
Alliance Spine and Pain Centers
Practice address
3685 Braselton Hwy Ste 100
Dacula, GA 30019-5920
Phone
(404) 920-4950
NPI assigned
Mar 16, 2021
Last updated
Mar 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X Primary

Addresses

Primary practice location

3685 Braselton Hwy Ste 100
Dacula, GA 30019-5920

Mailing address

3390 Peachtree Rd NE Ste 1500
Atlanta, GA 30326-2822
Phone (404) 920-4950

Other names 1

  • ALLIANCE SPINE AND PAIN CENTERS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ispm ASC at Camp Creek LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1861077315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 PEACHTREE RD NE STE 1500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303262822",
            "telephone_number": "404-920-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3685 BRASELTON HWY STE 100",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195920",
            "telephone_number": "404-920-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "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": "",
            "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"
        }
    ]
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.