NPIMap

Organization Active NPI

Pain Associates of South Georgia,LLC

  • Interventional Pain Medicine Physician
  • Brunswick, GA
National Provider Identifier
1891806345
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
038152 Issued in GA
Legal business name
PAIN ASSOCIATES OF SOUTH GEORGIA,LLC
Practice address
3408 Trout Street
Brunswick, GA 31520-3622
Phone
(912) 267-9000
Fax
(912) 267-9028
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Authorized official

Name
Dr. Michael J Lupi, DO
Title
Owner
Phone
(912) 267-9000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0014X GA
Interventional Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0014X 038152 GA Primary

Addresses

Primary practice location

3408 Trout Street
Brunswick, GA 31520-3622

Mailing address

3408 Trout Street
Brunswick, GA 31520-3622
Phone (912) 267-9000

Other identifiers 1

IdentifierTypeStateIssuer
DC0767OtherGARR MEDICARE GROUP

Other names 1

  • Pain Associates of South Georgia Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1891806345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3408 TROUT STREET",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203622",
            "telephone_number": "912-267-9000",
            "fax_number": "912-267-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3408 TROUT STREET",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203622",
            "telephone_number": "912-267-9000",
            "fax_number": "912-267-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN ASSOCIATES OF SOUTH GEORGIA,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "LUPI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-267-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "038152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "DC0767",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Associates of South Georgia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.