Active NPI
Georgia Interventional Pain - U, LLC
- Interventional Pain Medicine Physician
- Brunswick, GA
National Provider Identifier
1902769912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- Legal business name
- GEORGIA INTERVENTIONAL PAIN - U, LLC
- Practice address
- 1111 Glynco Pkwy Ste 26
Brunswick, GA 31525-7930 - Phone
- (770) 962-3642
- Fax
- (770) 962-3643
- NPI assigned
- Dec 5, 2025
- Last updated
- Mar 17, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amit Patel, MD
- Title
- Ceo
- Phone
- (770) 962-3642
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Pain Medicine Physician | 208VP0014X | NU | Primary |
Addresses
Primary practice location
1111 Glynco Pkwy Ste 26
Brunswick, GA 31525-7930
Mailing address
455 Philip Blvd Ste 140
Lawrenceville, GA 30046-8768
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
National Provider Directory
National Provider DirectoryLocations
1111 Glynco Pkwy
Ste 26
Brunswick, GA 31525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773705600000",
"number": "1902769912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 PHILIP BLVD STE 140",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300468768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 GLYNCO PKWY STE 26",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315257930",
"telephone_number": "770-962-3642",
"fax_number": "770-962-3643"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GEORGIA INTERVENTIONAL PAIN - U, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-12-05",
"last_updated": "2026-03-17",
"certification_date": "2026-03-17",
"status": "A",
"authorized_official_last_name": "PATEL",
"authorized_official_first_name": "AMIT",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "770-962-3642",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Brunswick, GA
- Georgia CVS Pharmacy LLC (CVS Pharmacy # 04567)
- Georgia Dental Professionals, PC (Seaside Lifetime Dentistry)
- Georgia Dental Professionals, PC (Dentistry by Angela Britt)
- Georgia DFCS Region 12
- Georgia Eye Institute of the Southeast, LLC
- Georgia Neurology and Rehab (Coastal Neurological Institute)
- Georgia Nurse Care, LLC
- Wendy Watkins Gerken, RPH
- Fatima Ghaffar, M.D.
- Habban Ghani
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.