NPIMap

Organization Active NPI

The Interventional Spine and Pain Management Center, PC

  • Interventional Pain Medicine Physician
  • Covington, GA
National Provider Identifier
1972963635
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
THE INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC
Practice address
5303 Adams St NE
Suite B
Covington, GA 30014-6208
Phone
(770) 929-9033
Fax
(770) 929-9092
NPI assigned
Feb 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Erin Sherrod
Title
Manager
Phone
(404) 492-4950

Specialties & licenses 1

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

Addresses

Primary practice location

5303 Adams St NE
Suite B
Covington, GA 30014-6208

Mailing address

3390 Peachtree Rd NE
Suite 1500
Atlanta, GA 30326-1157
Phone (404) 920-4950

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160218002303 GA DME Supplier - Physician - General Practice 2769483031 Practice locations: Covington, GA

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1972963635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 PEACHTREE RD NE",
            "address_2": "SUITE 1500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261157",
            "telephone_number": "404-920-4950",
            "fax_number": "404-920-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303 ADAMS ST NE",
            "address_2": "SUITE B",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300146208",
            "telephone_number": "770-929-9033",
            "fax_number": "770-929-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "SHERROD",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-492-4950"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.