Georgia Sports and Pain Physicians PC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

059870 Issued in GA

Legal business name

GEORGIA SPORTS AND PAIN PHYSICIANS PC

Practice address

4900 Ivey Rd NW
Suite 810
Acworth, GA 30101-4001

Phone

(850) 547-5789

Fax

(850) 547-5789

NPI assigned

May 24, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Ryan Helms, CPC

Title

Credentialing Agent

Phone

(850) 547-5789

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274659200000",
    "number": "1992024442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 IVEY RD NW",
            "address_2": "SUITE 810",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014001",
            "telephone_number": "850-547-5789",
            "fax_number": "850-547-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 IVEY RD NW",
            "address_2": "SUITE 810",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014001",
            "telephone_number": "850-547-5789",
            "fax_number": "850-547-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA SPORTS AND PAIN PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-24",
        "last_updated": "2010-05-24",
        "status": "A",
        "authorized_official_last_name": "HELMS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CREDENTIALING AGENT",
        "authorized_official_telephone_number": "850-547-5789",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "059870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "059870",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine Physician in Acworth, GA
• Providers in Acworth, GA by specialty
• Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.