NPIMap

Organization Active NPI

North Cobb Spine and Nerve Institute, LLC

  • Physical Medicine & Rehabilitation Physician
  • Acworth, GA
National Provider Identifier
1972922607
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
NORTH COBB SPINE AND NERVE INSTITUTE, LLC
Practice address
3451 Cobb Pkwy NW
Suite 4
Acworth, GA 30101-5766
Phone
(678) 574-5678
Fax
(678) 574-5605
NPI assigned
Apr 9, 2014
Last updated
Jul 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Authorized official

Name
Erin ArnoldNPI 1669709267
Title
Clinic Director
Phone
(678) 874-5678

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
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

3451 Cobb Pkwy NW
Suite 4
Acworth, GA 30101-5766

Mailing address

3451 Cobb Pkwy NW
Suite 4
Acworth, GA 30101-5766
Phone (678) 574-5678

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140715000705 GA Part B Supplier - Clinic/Group Practice 8527283134 Receives reassigned benefits from 9 practitioners
Practice locations: Acworth, GA
O20140717001625 GA DME Supplier - Multi-Specialty - Physician 8527283134 Practice locations: Acworth, GA

National Provider Directory

National Provider Directory

Locations

2450 Atlanta Hwy
Ste 601
Cumming, GA 30040
Phone (678) 574-5678

51 Market Square Rd
Ste G
Newnan, GA 30265
Phone (770) 683-4940

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1972922607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 COBB PKWY NW",
            "address_2": "SUITE 4",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015766",
            "telephone_number": "678-574-5678",
            "fax_number": "678-574-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 COBB PKWY NW",
            "address_2": "SUITE 4",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015766",
            "telephone_number": "678-574-5678",
            "fax_number": "678-574-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COBB SPINE AND NERVE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "ARNOLD",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "678-874-5678"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.