NPIMap

Organization Active NPI

Consultants in Pain Medicine, LLC

Doing business as Centurion Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • Brunswick, GA
National Provider Identifier
1902852130
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
041205 Issued in GA
Legal business name
CONSULTANTS IN PAIN MEDICINE, LLC
Doing business as
Centurion Spine & Pain Centers
Practice address
3408 Trout St
Brunswick, GA 31520-3622
Phone
(912) 466-9111
Fax
(912) 466-0366
NPI assigned
May 26, 2006
Last updated
May 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Authorized official

Name
Alicia Groth (Ao)
Title
Credentialing
Phone
(904) 223-3321

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 041205 GA
Pain Medicine (Anesthesiology) Physician 207LP2900X 041205 GA
Interventional Pain Medicine Physician 208VP0014X 041205 GA Primary

Addresses

Primary practice location

3408 Trout St
Brunswick, GA 31520-3622

Mailing address

5191 First Coast Tech Pkwy FL 3
Jacksonville, FL 32224-0609
Phone (904) 256-2754

Other practice location 1

613 Stephenson Ave Ste 206
Savannah, GA 31405-5841
Phone (912) 590-0973

Other practice location 2

1601 Fair Rd Ste 800
Statesboro, GA 30458-0800
Phone (912) 590-0973

Other practice location 3

2658 US Highway 17
Richmond Hill, GA 31324-3374
Phone (912) 590-0973

Other practice location 4

1218 Alice St
Waycross, GA 31501-4525
Phone (912) 590-0973

Other practice location 5

200 Blue Moon Xing Ste 203
Pooler, GA 31322-9698
Phone (912) 254-7896

Other names 1

  • Centurion Spine & Pain Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040923000559 GA Part B Supplier - Clinic/Group Practice 7911975248 Receives reassigned benefits from 18 practitioners
Practice locations: Brunswick, GA; Pooler, GA; Richmond Hill, GA; Savannah, GA; Waycross, GA; Statesboro, GA
O20101102001515 GA DME Supplier - Physician - AnesthesiologyDME Supplier - Physician - Physical and Rehabilitation 7911975248 Practice locations: Brunswick, GA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2248990Centurion Spine and Pain3408 Trout Street, Brunswick, GA 31520Certificate of waiverJan 17, 2028

National Provider Directory

National Provider Directory

Locations

195 E Tollison St
Bldg C
Baxley, GA 31513
Phone (912) 590-0973

3221 Glynn Ave
#100
Brunswick, GA 31520

200 Blue Moon Xing
Ste 200
Pooler, GA 31322

612 Stephenson Ave Ste 206
Savannah, GA 31405

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779753600000",
    "number": "1902852130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-256-2754",
            "fax_number": "904-223-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3408 TROUT ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203622",
            "telephone_number": "912-466-9111",
            "fax_number": "912-466-0366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "613 Stephenson Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314055841",
            "country_code": "US",
            "telephone_number": "912-590-0973",
            "fax_number": "912-590-0180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1601 Fair Rd Ste 800",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304580800",
            "country_code": "US",
            "telephone_number": "912-590-0973",
            "fax_number": "912-590-0180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2658 US Highway 17",
            "address_purpose": "LOCATION",
            "city": "Richmond Hill",
            "state": "GA",
            "postal_code": "313243374",
            "country_code": "US",
            "telephone_number": "912-590-0973",
            "fax_number": "912-590-0180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1218 Alice St",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315014525",
            "country_code": "US",
            "telephone_number": "912-590-0973",
            "fax_number": "912-590-0180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Blue Moon Xing Ste 203",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313229698",
            "country_code": "US",
            "telephone_number": "912-254-7896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONSULTANTS IN PAIN MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A",
        "authorized_official_last_name": "GROTH (AO)",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "904-223-3321"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "041205",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "041205",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "041205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centurion Spine & Pain Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centurion Spine & Pain Centers",
            "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 May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.