SJ & J Spine and Pain Group Holding LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

058527 Issued in GA

Legal business name

SJ & J SPINE AND PAIN GROUP HOLDING LLC

Practice address

91 Sammy McGhee Blvd, Suite 101
Jasper, GA 30143

Phone

(706) 253-3341

NPI assigned

Aug 4, 2015

Organization subpart

No

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

Authorized official

Name

Sallu Jabati

Title

MD/Medical Director

Phone

(678) 559-4526

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1871979641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 SAMMY MCGHEE BLVD, SUITE 101",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "30143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 SAMMY MCGHEE BLVD, SUITE 101",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "30143",
            "telephone_number": "706-253-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJ & J SPINE AND PAIN GROUP HOLDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "JABATI",
        "authorized_official_first_name": "SALLU",
        "authorized_official_title_or_position": "MD/MEDICAL  DIRECTOR",
        "authorized_official_telephone_number": "678-559-4526"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "058527",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "058527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patti Lynn Shelby, FNP
• Samantha Mary Shepherd, DPT, PT
• Caitlyn Shoffer
• Alison Hodges Sills, RPH
• Amber Lanone Sisk, LDO
• Sleep Servicfes of Jasper, LLC
• Daniel Phillip Smith, DMD
• Jennifer Smith
• Sonya Smith, RN
• Joe Taltson Southerland, DPM

• All providers in Jasper, GA
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.