Organization Active NPI

Apollo Spine and Pain Center

  • Interventional Pain Medicine Physician
  • Cumming, GA
National Provider Identifier
1891302998
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
APOLLO SPINE AND PAIN CENTER
Practice address
4415 Front Nine Dr
Cumming, GA 30041-6063
Phone
(614) 905-2700
NPI assigned
Sep 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Authorized official

Name
Dr. Ramya Nagarajan Rangaraj, MDNPI 1184823650
Title
Physician
Phone
(678) 771-8266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

4415 Front Nine Dr
Cumming, GA 30041-6063

Mailing address

4415 Front Nine Dr Ste 700
Cumming, GA 30041-6239
Phone (678) 771-8266

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL cloud Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201203000289 GA Part B Supplier - Clinic/Group Practice 5193136752 Receives reassigned benefits from 1 practitioner
Practice locations: Cumming, GA; Jasper, GA

National Provider Directory

National Provider Directory

Locations

4415 Front Nine Dr
Cumming, GA 30041
Phone (614) 905-2700

4415 Front Nine Dr
Ste 600
Cumming, GA 30041
Phone (678) 456-8463

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1891302998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 FRONT NINE DR STE 700",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416239",
            "telephone_number": "678-771-8266",
            "fax_number": "678-456-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 FRONT NINE DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416063",
            "telephone_number": "614-905-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO SPINE AND PAIN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "RANGARAJ",
        "authorized_official_first_name": "RAMYA",
        "authorized_official_middle_name": "NAGARAJAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "678-771-8266",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cloud",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4415 Front Nine Dr",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300416063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.