INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER (NPI# 1750420147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750420147 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER |
| Other Organization Name | ISPM ASC |
| Practice Address |
1388 Wellbrook Cir Ne Suite A Conyers GA 30012-3872 |
| Mailing Address |
Po Box 11407 Dept 2344 Birmingham AL 35246-3872 |
| Practice Telephone | 7709299033 |
| Practice Fax Number | 7709299092 |
| Mailing Telephone | 7709299033 |
| Mailing Fax Number | 7709299092 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-02-29 |
| Authorized Official Name | MRS. VICTORIA BECK (CFO) |
| Authorized Official Telephone | 4049204950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ISPM ASC | Former Legal Business Name - Organization |
| Street Address |
1388 WELLBROOK CIR NE SUITE A |
| City | CONYERS |
| State | GA |
| Zip Code | 30012-3872 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235185141 | Robin J. Fowler | Pain Medicine | 1388 Wellbrook Cir Ne, Suite A, Conyers, GA 30012-3872 | 2006-05-25 |
| 1023481918 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 1388 Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2015-11-02 |
| 1518128289 | Greater Anesthesia Services LLC | Specialist | 1388 Wellbrook Cir Ne, Suite A, Conyers, GA 30012-3872 | 2008-06-24 |
| 1013084136 | Marcia E Steinberg | Nurse Anesthetist, Certified Registered | 1388 Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
| 1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
| 1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
| 1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
| 1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
| 1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
| Find all providers in zip 30012 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164953493 | Eastside Endoscopy Center, LLC | Clinic/Center | 1805 Honey Creek Cmns Se, Conyers, GA 30013-5828 | 2017-03-27 |
| 1629222815 | Georgia Urology, Pa | Clinic/Center | 1301 Sigman Rd Ne Ste 250b, Conyers, GA 30012-3812 | 2008-11-14 |
| 1609065903 | Laurus Surgical, L.l.c | Clinic/Center | 1388a Wellbrook Cir Ne, Conyers, GA 30012-3872 | 2007-10-23 |
| 1558899682 | East Atlanta Endoscopy Centers, LLC | Clinic/Center | 1269 Wellbrook Cir Ne, Conyers, GA 30012-3873 | 2017-06-02 |
| 1053846592 | Eastside Endoscopy Center LLC | Clinic/Center | 1805 Honey Creek Cmns Se, Conyers, GA 30013-5828 | 2017-04-21 |
| 1518009430 | Wellbrook Endoscopy Center, PC | Clinic/Center | 1269 Wellbrook Cir Ne, Conyers, GA 30012-3873 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372963 | Alliance Surgery Center At Peachtree City LLC | Clinic/Center | 1975 Highway 54 W Ste 105, Peachtree City, GA 30269-4794 | 2020-09-29 |
| 1518579903 | Amin Surgery Center for Women LLC | Clinic/Center | 1150b Kirkland Ln, Douglas, GA 31533-2044 | 2020-08-18 |
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1720602683 | Georgia Eye Surgery LLC | Clinic/Center | 1620 Prince Ave Ste B, Athens, GA 30606-6008 | 2020-06-05 |
| 1750905618 | Rsps Fayetteville Asc Lllp | Clinic/Center | 874 Lanier Ave W Ste 270, Fayetteville, GA 30214-7617 | 2020-06-05 |
| 1699395541 | Medici Surgical Center Gwinnett, LLC | Clinic/Center | 2220 Wisteria Dr Ste 100, Snellville, GA 30078-4604 | 2020-04-21 |
| 1114552338 | Georgia Interventional Pain - G, LLC | Clinic/Center | 1504 N Thornton Ave Ste 104, Dalton, GA 30720-8394 | 2020-03-09 |
| 1700424322 | Georgia Interventional Pain - F, LLC | Clinic/Center | 1357 Hembree Rd Ste 230, Roswell, GA 30076-5725 | 2019-12-13 |
| 1699328369 | Georgia Urology, Pa | Clinic/Center | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-07-22 |
| 1912563941 | Commerce Ambulatory Surgery Center, Inc. | Clinic/Center | 417 Pottery Factory Dr, Commerce, GA 30529-6682 | 2019-05-15 |
| Find all providers with the same taxonomy | ||||
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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.