INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC (NPI# 1518012004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518012004 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC |
| Other Organization Name | ALLIANCE SPINE AND PAIN CENTERS |
| Practice Address |
110 Evans Mill Dr Suite 803 Dallas GA 30157-1622 |
| Mailing Address |
3390 Peachtree Rd Ne Suite 1500 Atlanta GA 30326-1157 |
| Practice Telephone | 4049204950 |
| Practice Fax Number | 4049204959 |
| Mailing Telephone | 7709299033 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2016-04-15 |
| Authorized Official Name | MR. ROBIN J FOWLER (OWNER) |
| Authorized Official Telephone | 7709299033 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Alliance Spine and Pain Centers | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235756792 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 2100 Central Ave Ste 6, Augusta, GA 30904-6709 | 2020-07-01 |
| 1114578515 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6002 Highway 53 E Ste 110, Dawsonville, GA 30534-6227 | 2019-09-26 |
| 1467014936 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6920 Mcginnis Ferry Rd Ste 360b, Suwanee, GA 30024-6672 | 2019-07-03 |
| 1265892293 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6002 Hwy 52 East, Suite 110, Dawsonville, GA 30534 | 2016-03-03 |
| 1083212963 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 1975 Highway 54 W Ste 100, Peachtree City, GA 30269-4794 | 2020-10-13 |
| 1598127540 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 3885 Princeton Lakes Way Sw, Atlanta, GA 30331-5589 | 2016-03-28 |
| 1326409566 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 3885 Princeton Lakes Way Sw, Suite 225, Atlanta, GA 30331-5589 | 2016-03-16 |
| 1972963635 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 5303 Adams St Ne, Suite B, Covington, GA 30014-6208 | 2016-02-24 |
| 1669831327 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 812 S Park St, Suite 5b, Carrollton, GA 30117-4412 | 2016-02-23 |
| 1154780914 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 2675 N Decatur Rd, Suite 303, Decatur, GA 30033-6131 | 2016-02-22 |
| Street Address |
110 EVANS MILL DR SUITE 803 |
| City | DALLAS |
| State | GA |
| Zip Code | 30157-1622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184795080 | Mark Stephen Wolfe | Marriage & Family Therapist | 110 Evans Mill Dr, Dallas, GA 30157-1622 | 2006-11-13 |
| 1669906228 | Odette Amanda Prince | Registered Nurse | 110 Evans Mill Dr, Dallas, GA 30157-1622 | 2017-04-20 |
| 1851836597 | Second Chance Or More Counseling Services | Community/Behavioral Health | 110 Evans Mill Dr, Suite 401, Dallas, GA 30157-1622 | 2017-01-05 |
| 1780032490 | Warren Smith | Chiropractor | 110 Evans Mill Dr, Suite 301, Dallas, GA 30157-1622 | 2016-06-03 |
| 1669820379 | Precision Chiropractic Corporation | Chiropractor | 110 Evans Mill Dr, Suie 301, Dallas, GA 30157-1622 | 2016-06-03 |
| 1245612191 | Ironwood Counseling LLC | Counselor | 110 Evans Mill Dr, Dallas, GA 30157-1622 | 2015-06-26 |
| 1215338652 | Diana Keys | Counselor | 110 Evans Mill Dr, Dallas, GA 30157-1622 | 2014-09-04 |
| 1316376890 | Kimdi Joy Fair | Chiropractor | 110 Evans Mill Dr, Suite 105, Dallas, GA 30157-1622 | 2013-11-05 |
| 1093144768 | Jeffrey Kilheffer | Chiropractor | 110 Evans Mill Dr, Dallas, GA 30157-1622 | 2013-11-04 |
| 1255767232 | Jno, Inc. | In Home Supportive Care | 110 Evans Mill Dr, Suite 801, Dallas, GA 30157-1622 | 2013-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608629 | Harshadbhai Vinubhai Patel | Pharmacist | 3615 Marietta Highway, Dallas, GA 30157 | 2020-10-30 |
| 1043852627 | Lindsay Sheets | Dentist | 59 Hillside Trce Ste 105, Dallas, GA 30157 | 2019-10-15 |
| 1619459062 | Emily Nicole Koopman | Specialist/Technologist | 399 Powder Creek Way, Dallas, GA 30157 | 2018-09-02 |
| 1073969861 | Rachel Spencer | Physical Therapist | 99 Hillside Trace, Dallas, GA 30157 | 2016-05-11 |
| 1336514827 | Petal Shields | Community Health Worker | 121 Omega Ct, Dallas, GA 30157 | 2015-12-09 |
| 1851797294 | Annette Moncion | Nurse Practitioner | 32 Midland Lane, Dallas, GA 30157 | 2014-11-12 |
| 1003211079 | Melissa Brice | Lactation Consultant, Non-RN | 430 Parson Rd, Dallas, GA 30157 | 2014-11-03 |
| 1104101690 | Jared Alan Lott | Pharmacist | 303 Charlie Watts Blvd, Dallas, GA 30157 | 2011-10-15 |
| 1972888758 | Lisa Nicole Mcentire | Massage Therapist | 119 Fairview Oak Trace, Dallas, GA 30157 | 2011-10-12 |
| 1548570120 | Chad Stough | Physician Assistant | 2713 Marietta Highway, Suite 122, Dallas, GA 30157 | 2010-10-15 |
| Find all providers in zip 30157 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275172827 | Tina Mone Patterson | Specialist | 8501 Old Hickory Trl Apt 2106, Dallas, TX 75237-3821 | 2019-12-31 |
| 1225670862 | Camerin J Cole | Specialist | 4701 Haverwood Ln Apt 112, Dallas, TX 75287-4206 | 2019-10-15 |
| 1356833198 | Diana Denise Demasi | Specialist | 4411 Lemmon Ave Ste 102, Dallas, TX 75219-2390 | 2018-06-06 |
| 1942718242 | Kristy Prieto | Specialist | 18809 Lina St Apt 10209, Dallas, TX 75287-2519 | 2018-01-21 |
| 1306354600 | Johnneshia Donald | Specialist | 3702 Frankford Rd Apt 12303, Dallas, TX 75287-7808 | 2018-01-21 |
| 1841740404 | Surgical Associates of Dallas | Specialist | 621 N Hall St Ste 520, Dallas, TX 75226-1315 | 2016-10-07 |
| 1194198101 | Surepoint Emergency Physicians Denton, Pllc | Specialist | 5005 Lbj Fwy, Suite 1200, Dallas, TX 75244 | 2015-11-12 |
| 1316329071 | Southern Spine Institute Pllc | Specialist | 11970 N Central Expy Ste 450, Dallas, TX 75243-3787 | 2015-06-18 |
| 1760886345 | Wls Surgical Associates of North Texas Pllc | Specialist | 7777 Forest Ln Ste C400, Dallas, TX 75230-7516 | 2014-10-10 |
| 1952731804 | Aw Sleep Diagnostic Center Inc | Specialist | 13154 Coit Road, Suite 105, Dallas, TX 75240-5787 | 2013-11-13 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.