NPIMap

Organization Active NPI

Consultants in Pain Medicine, LLC

Doing business as Centurion Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • Savannah, GA
National Provider Identifier
1942052022
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
CONSULTANTS IN PAIN MEDICINE, LLC
Doing business as
Centurion Spine & Pain Centers
Practice address
613 Stephenson Ave Ste 206
Savannah, GA 31405-5841
Phone
(912) 590-0973
Fax
(912) 590-0180
NPI assigned
Apr 3, 2024
Last updated
Apr 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X NU Primary

Addresses

Primary practice location

613 Stephenson Ave Ste 206
Savannah, GA 31405-5841

Mailing address

5191 First Coast Tech Pkwy FL 3
Jacksonville, FL 32224-0609
Phone (904) 223-3321

Other names 1

  • Centurion Spine & Pain Centers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250523000700 GA DME Supplier - Physician - Interventional Pain Management 7911975248 Practice locations: Savannah, 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
11D2302120Centurion Spine and Pain Centers - Savannah613 Stephenson Avenue, Suite 206, Savannah, GA 31405Certificate of waiverApr 3, 2028

National Provider Directory

National Provider Directory
Tax ID family
Consultants in Pain Medicinellc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3100 Kemble Ave
Brunswick, GA 31520
Phone (880) 233-2570

11706 Mercy Blvd
Ste 7A
Savannah, GA 31419
Phone (912) 537-4414

303 Harris Industrial Blvd
Ste 2
Vidalia, GA 30474
Phone (912) 537-4414

1507 Alice St
Waycross, GA 31501
Phone (912) 283-7220

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1942052022",
    "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": "904-223-3321",
            "fax_number": "904-223-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 STEPHENSON AVE STE 206",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055841",
            "telephone_number": "912-590-0973",
            "fax_number": "912-590-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTANTS IN PAIN MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "GROTH",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "904-223-3321"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centurion Spine & Pain Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.