ACE PAIN AND SPINE LLC (NPI# 1811515554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811515554 |
| Entity Type | Organization |
| Organization Name | ACE PAIN AND SPINE LLC |
| Practice Address |
3625 Braselton Hwy Ste 201 Dacula GA 30019-4695 |
| Mailing Address |
2725 Hamilton Mill Rd Suite 500 Box 240 Buford GA 30519 |
| Practice Telephone | 6784042220 |
| Mailing Telephone | 6784042220 |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |
| Authorized Official Name | DR. CORY MANSOUR (PHYSICIAN / OWNER) |
| Authorized Official Telephone | 6784042220 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Street Address |
3625 BRASELTON HWY STE 201 |
| City | DACULA |
| State | GA |
| Zip Code | 30019-4695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326453796 | Emily Miyuki Kurokawa | Anesthesiology | 3625 Braselton Hwy Ste 201, Dacula, GA 30019-4695 | 2014-06-24 |
| 1457869265 | Center for Spine & Pain Medicine PC | Durable Medical Equipment & Medical Supplies | 3625 Braselton Hwy Ste 201, Dacula, GA 30019-4695 | 2018-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228171 | Mackenson Lafortune | Physical Therapy Assistant | 1424 Filigree Pl, Dacula, GA 30019 | 2019-10-29 |
| 1780167452 | Adenike Alaga | Registered Nurse | 3196 Dolostone Way, Dacula, GA 30019 | 2018-09-10 |
| 1780160580 | Cielitha Ruffin | Nurse Practitioner | 1223 Bentley Estates Dr., Dacula, GA 30019 | 2018-07-15 |
| 1386135663 | Anke Mbapeh | Nurse Practitioner | 2100 Browning Bend Ct, Dacula, GA 30019 | 2018-05-23 |
| 1053820282 | Ethan Zachariah Merrow | Student in an Organized Health Care Education/Training Program | 1701 Mulberry Lake Drive, Dacula, GA 30019 | 2017-09-20 |
| 1043737547 | Dawn Hedley | Dietitian, Registered | 3567 Vern Way, Dacula, GA 30019 | 2017-08-25 |
| 1831545367 | Angela Owusu-edusei | Nurse Practitioner | 3226 Dolostone Way, Dacula, GA 30019 | 2016-05-13 |
| 1528458718 | Philomena Gyamfi | Registered Nurse | 1088 Milford Ln, Dacula, GA 30019 | 2015-01-27 |
| 1417375247 | Casey Goldman Sommerfeld | Pediatrics | 2240 Hamilton Creek Pkwy Ste 600, Dacula, GA 30019 | 2014-03-29 |
| 1417398215 | Samia Tahil | Home Health | 2821 Spence Ct, Dacula, GA 30019 | 2013-07-10 |
| Find all providers in zip 30019 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558970640 | Fx Spine and Performance Center, LLC | Clinic/Center | 106 Srp Dr Ste B, Evans, GA 30809-4358 | 2020-07-24 |
| 1083253140 | Intercare Medical, Corp | Clinic/Center | 3540 Wheeler Rd Ste 307, Augusta, GA 30909-1887 | 2020-01-06 |
| 1346763190 | Laser Spine & Pain Centers LLC | Clinic/Center | 403 Permian Way Ste C, Villa Rica, GA 30180-3252 | 2017-07-24 |
| 1164828976 | Atlanta Pain and Wellness Center PC | Clinic/Center | 1287 Ga Hwy 138 Spur Ste 8, Jonesboro, GA 30236-2419 | 2014-11-06 |
| 1790031664 | Nr Medical Center, LLC | Clinic/Center | 213 Arrowhead Blvd, Suite D, Jonesboro, GA 30236-1168 | 2012-07-30 |
| 1740566181 | Physical Medicine of Norcross | Clinic/Center | 6315 Spaulding Dr Ste B, Norcross, GA 30092-4653 | 2011-10-31 |
| 1407131899 | Cambridge Labs,llc | Clinic/Center | 611 15th St, Augusta, GA 30901-2601 | 2011-10-17 |
| 1043537905 | Primacare Pain & Rehab.,llc | Clinic/Center | 4467 Glenwood Rd, Suite 2, Decatur, GA 30032-5014 | 2010-04-30 |
| 1194994244 | Ernie E Lin | Clinic/Center | 211 Pleasant Home Road, Suite F-3, Augusta, GA 30907-0559 | 2008-02-22 |
| 1235354218 | Acworth Pain Management Center Inc | Clinic/Center | 5399 Bells Ferry Rd, Suite 180, Acworth, GA 30102-7546 | 2007-04-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ACE PAIN AND SPINE LLC.
| 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.