SOUTH ATLANTA NEUROLOGY & PAIN CLINIC, PC (NPI# 1639331150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639331150 |
| Entity Type | Organization |
| Organization Name | SOUTH ATLANTA NEUROLOGY & PAIN CLINIC, PC |
| Other Organization Name | OPEN MRI OF SANPC |
| Practice Address |
1040 Eagles Landing Pkwy Ste 102 Stockbridge GA 30281-9073 |
| Mailing Address |
Po Box 1198 Fayetteville GA 30214-6198 |
| Practice Telephone | 7705077359 |
| Practice Fax Number | 7705078390 |
| Mailing Telephone | 7705077359 |
| Mailing Fax Number | 7705078390 |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2011-01-19 |
| Authorized Official Name | DR. BRICE BYUNG-IL CHOI (OWNER/PRESIDENT) |
| Authorized Official Telephone | 7705077359 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 044899 | GA | Other Service Providers |
| N | 2084P2900X |
Psychiatry & Neurology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2085D0003X |
Radiology Specialization: Diagnostic Neuroimaging |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000783989F | 05 | |
| GA | INDIVIDUAL NPI # | 1174554455 | 01 |
| Other Name | Type Code |
|---|---|
| OPEN MRI OF SANPC | Other Name - Individual/Organization |
| Street Address |
1040 EAGLES LANDING PKWY STE 102 |
| City | STOCKBRIDGE |
| State | GA |
| Zip Code | 30281-9073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386632941 | Manohar N Nallathambi | Surgery | 1040 Eagles Landing Pkwy, Suite100, Stockbridge, GA 30281-9072 | 2005-10-07 |
| 1346449758 | Monica S. Mosley | Dentist | 1040 Eagles Landing Pkwy, Suite 200, Stockbridge, GA 30281-9072 | 2007-07-16 |
| 1861527616 | Surgery South PC | Surgery | 1040 Eagles Landing Pkwy, Suite 100, Stockbridge, GA 30281-9072 | 2007-02-22 |
| 1114069424 | Hank R. Dallam | Dentist | 1040 Eagles Landing Pkwy, Suite 200, Stockbridge, GA 30281-9072 | 2007-02-13 |
| 1013003300 | Ahmad Ibn Nuriddin | Surgery | 1040 Eagles Landing Pkwy, Suite 100, Stockbridge, GA 30281-9072 | 2006-10-05 |
| 1871686402 | Omar Mohammed Shariff | Dentist | 1040 Eagles Landing Pkwy, Suite 200, Stockbridge, GA 30281-9072 | 2006-10-02 |
| 1174554455 | Brice Choi | Specialist | 1040 Eagles Landing Pkwy, 102, Stockbridge, GA 30281-9072 | 2006-07-05 |
| 1083602643 | Brian S Myers | Surgery | 1040 Eagles Landing Pkwy, Suite 100, Stockbridge, GA 30281-9072 | 2005-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039095 | Colette Alls | Social Worker | 447 Lakeshore Dr, Stockbridge, GA 30281 | 2020-09-24 |
| 1982216800 | Pediatric and Family Behavioral Health of Georgia | Counselor | 1004 Ulster Court, Stockbridge, GA 30281 | 2020-08-21 |
| 1518577659 | Qunique Taveka Toxey | Behavior Technician | 115 N Park Trail, Suite 123, Stockbridge, GA 30281 | 2020-08-04 |
| 1497377675 | Melanie Harvey | Pharmacist | 4467 North Henry Boulevard, Stockbridge, GA 30281 | 2020-05-11 |
| 1114550571 | Cecile Maria Dunkley Layne | Counselor | 255 Corporte Drive, Stockbridge, GA 30281 | 2020-02-13 |
| 1306407143 | Palliative Care of Georgia. LLC | Home Health | 275 Corporate Center Court Ste C, Stockbridge, GA 30281 | 2019-06-24 |
| 1154883791 | Aaliyah Nura Fardan-alexander | Nurse's Aide | 105 Singletree, Stockbridge, GA 30281 | 2019-04-02 |
| 1306306261 | Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 150 County Club Drive, Suite 200, Stockbridge, GA 30281 | 2019-03-25 |
| 1356814172 | Kristina Louissaint | Nurse Practitioner | 650 Country Club Dr, Stockbridge, GA 30281 | 2019-01-03 |
| 1942789284 | Cameren Barnes | Physical Therapist | 5473 N Henry Blvd, Stockbridge, GA 30281 | 2018-08-08 |
| Find all providers in zip 30281 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972767754 | Atlanta Neurology and Electrodiagnostic Center, PC | Psychiatry & Neurology | 260 Corporate Center Dr, Suite C, Stockbridge, GA 30281-7215 | 2008-07-11 |
| 1093098469 | Neurocare Institute of Georgia | Psychiatry & Neurology | 135 Eagles Walk, Suite 150, Stockbridge, GA 30281-7206 | 2011-09-22 |
| 1871892547 | Pruthu P Patel | Psychiatry & Neurology | 1133 Eagles Landing Pkwy, Stockbridge, GA 30281-5085 | 2011-03-21 |
| 1295969665 | Ogonna Adaobi Iwuora | Psychiatry & Neurology | 135 N Park Pl Ste 200, Stockbridge, GA 30281-7209 | 2009-05-13 |
| 1740328996 | Raghuarm Kolanu | Psychiatry & Neurology | 1050 Eagles Landing Pkwy, Ste #203, Stockbridge, GA 30281 | 2007-02-01 |
| 1861530016 | Neurology South PC | Psychiatry & Neurology | 1050 Eagles Landing Pkwy, Ste 203, Stockbridge, GA 30281 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013544899 | Southern Neurology, Physical Medicine & Rehabilitation, LLC | Psychiatry & Neurology | 4913 Lanes Pond Rd, Valdosta, GA 31601-1537 | 2020-03-24 |
| 1912474537 | Atlanta Neuromonitoring, LLC | Psychiatry & Neurology | 922 Highway 81 East # 242, Mcdonough, GA 30252 | 2018-11-01 |
| 1366925497 | David Wayne Richardson | Psychiatry & Neurology | 400 Rock Springs Road Ne, Atlanta, GA 30324 | 2018-09-14 |
| 1407349103 | Ahmed Babiker | Psychiatry & Neurology | 1130 15th St, Augusta, GA 30912-0004 | 2018-06-07 |
| 1811342561 | The Migraine and Spine Clinic of Valdosta LLC | Psychiatry & Neurology | 3315 N Valdosta Rd, Suite A, Valdosta, GA 31602-1107 | 2016-05-02 |
| 1164882635 | Lafayette Neurology, PC | Psychiatry & Neurology | 1075 Lafayette Parkway, Suite 210, Lagrange, GA 30241-3584 | 2016-02-26 |
| 1144601048 | Catherine Lockhart | Psychiatry & Neurology | 2470 Daniels Bridge Rd Ste 261, Athens, GA 30606-6188 | 2015-06-16 |
| 1609266634 | Bruce Gillett | Psychiatry & Neurology | 948 Greymont Cir Nw, Marietta, GA 30064-1328 | 2015-01-29 |
| 1245620244 | Darla R Totten Md | Psychiatry & Neurology | 3780 Northside Dr, 197, Macon, GA 31210-2431 | 2015-01-28 |
| 1033516356 | Neuro Proread Solutions | Psychiatry & Neurology | 2378 Riderwood Court, Marietta, GA 30062-4689 | 2014-12-02 |
| Find all providers with the same taxonomy | ||||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
Please comment or provide details below to improve the information on SOUTH ATLANTA NEUROLOGY & PAIN CLINIC, PC.
| 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.