NPIMap

Organization Active NPI

Center for Spine & Pain Medicine PC

  • Ambulatory Surgical Clinic/Center
  • Gainesville, GA
National Provider Identifier
1982186425
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CENTER FOR SPINE & PAIN MEDICINE PC
Practice address
715 Queen City Pkwy Ste 106
Gainesville, GA 30501-4335
Phone
(678) 450-1222
Fax
(706) 279-2679
NPI assigned
Aug 31, 2018
Organization subpart
Yes
Parent organization
CENTER FOR SPINE & PAIN MEDICINE PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Shahid Sohani
Title
Practice Manager
Phone
(678) 450-1222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

715 Queen City Pkwy Ste 106
Gainesville, GA 30501-4335

Mailing address

1413 Chattanooga Ave
Dalton, GA 30720-2631
Phone (706) 279-2635

Other names 1

  • CSPM GSV ASC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181128002786 GA Part B Supplier - Ambulatory Surgical Center 6709875297 Receives reassigned benefits from 4 practitioners
Practice locations: Gainesville, GA

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Center for Spine and Pain Medicine Dba CSPM GSV ASCCCN 11C0001497
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Center for Spine Pain M4 organizations share this tax ID, including this one
Part of
Center for Spine Pain M

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1982186425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 CHATTANOOGA AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202631",
            "telephone_number": "706-279-2635",
            "fax_number": "706-279-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 QUEEN CITY PKWY STE 106",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305014335",
            "telephone_number": "678-450-1222",
            "fax_number": "706-279-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR SPINE & PAIN MEDICINE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTER FOR SPINE & PAIN MEDICINE PC",
        "enumeration_date": "2018-08-31",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "SOHANI",
        "authorized_official_first_name": "SHAHID",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "678-450-1222"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSPM GSV ASC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.