PEACHTREE SPINE & PAIN PHYSICIANS, INC (NPI# 1831407535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831407535 |
| Entity Type | Organization |
| Organization Name | PEACHTREE SPINE & PAIN PHYSICIANS, INC |
| Other Organization Name | PEACHTREE SPINE PHYSICIANS, INC |
| Practice Address |
4705 Lawrenceville Hwy Nw Ste A Lilburn GA 30047-3667 |
| Mailing Address |
5555 Peachtree Dunwoody Rd Ne Ste 201 Atlanta GA 30342-1711 |
| Practice Telephone | 4048433323 |
| Practice Fax Number | 4045745944 |
| Mailing Telephone | 4048433323 |
| Mailing Fax Number | 4045745944 |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2010-09-16 |
| Authorized Official Name | DR. JEFFREY S GROSSMAN (PRESIDENT) |
| Authorized Official Telephone | 4048433323 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | PEACHTREE SPINE & PAIN PHYSICIANS, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
046109 | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Peachtree Spine Physicians, Inc | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336458355 | Peachtree Spine & Pain Physicians, Inc | Physical Medicine & Rehabilitation | 771 Virginia Ave, Hapeville, GA 30354-1911 | 2010-09-27 |
| 1881902575 | Peachtree Spine & Pain Physicians, Inc | Physical Medicine & Rehabilitation | 711 Canton Rd Ne Ste 200, Marietta, GA 30060-8949 | 2010-09-16 |
| 1043527708 | Peachtree Spine & Pain Physicians, Inc | Physical Medicine & Rehabilitation | 4255 Johns Creek Pkwy Ste C, Suwanee, GA 30024-6122 | 2010-09-01 |
| 1326355082 | Peachtree Spine & Pain Physicians, Inc | Family Medicine | 315 W Ponce De Leon Ave Ste 970, Decatur, GA 30030-2471 | 2010-09-01 |
| Street Address |
4705 LAWRENCEVILLE HWY NW STE A |
| City | LILBURN |
| State | GA |
| Zip Code | 30047-3667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750861217 | Latrina S Walden | Nurse Practitioner | 887 Ryan Lane, Lilburn, GA 30047 | 2018-08-15 |
| 1811483928 | Olivia Oyegunle | Optometrist | 4153 Lawrenceville Hwy Nw Ste 5, Lilburn, GA 30047 | 2018-07-02 |
| 1932619285 | Mpm Creative, LLC | Speech-Language Pathologist | 1560 Hewatt Rd, Lilburn, GA 30047 | 2017-10-01 |
| 1528515186 | Smith Dental Care of Lilburn, Inc. | Dentist | 3100 Five Forks Trickham Rd Suite 201, Lilburn, GA 30047 | 2016-09-01 |
| 1891143244 | Choices Behavioral Alternatives | Counselor | 4037 Darling Court, Suite B, Lilburn, GA 30047 | 2016-05-26 |
| 1235595687 | Georgia Dental Associates | Clinic/Center | 3100 Five Forks Trickum Road Suite 201, Lilburn, GA 30047 | 2016-01-14 |
| 1912382144 | Sangeetha Asokan | Dentist | 609, Beaver Ruin Road, Tebo Dental for Kids, Lilburn, GA 30047 | 2015-07-29 |
| 1467836403 | Pamela Neal | Registered Nurse | 3315 Landingview Ct, Lilburn, GA 30047 | 2015-07-18 |
| 1699172452 | Josie Kou, Kulah Curran | Registered Nurse | 3708 Tamer Ln, Lilburn, GA 30047 | 2014-11-21 |
| 1184039380 | Cheryl Lee | Chiropractor | 5014 Stone Mountain Hwy, Suite C, Lilburn, GA 30047 | 2014-06-25 |
| Find all providers in zip 30047 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043671761 | Pain Management and Rehabilitation Inc | Physical Medicine & Rehabilitation | 3955 Lawrenceville Hwy Nw, Lilburn, GA 30047-2996 | 2016-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490091 | Interventional and Alternative Spine and Wellness, LLC | Physical Medicine & Rehabilitation | 3630 Wheeler Rd, Augusta, GA 30909-6561 | 2020-09-03 |
| 1881205151 | Georgia Regenrx, LLC. | Physical Medicine & Rehabilitation | 5755 N Point Pkwy Ste 72, Alpharetta, GA 30022-1146 | 2020-08-11 |
| 1710514989 | Jennifer Meyer | Physical Medicine & Rehabilitation | 1554 Riverstone Pkwy Ste 160, Canton, GA 30114-2887 | 2020-03-26 |
| 1982172060 | Back To Life Pain Center, LLC | Physical Medicine & Rehabilitation | 410 Creekstone Rdg, Woodstock, GA 30188-3740 | 2018-11-07 |
| 1760900708 | Neuro Diagnostic Group LLC | Physical Medicine & Rehabilitation | 200 Galleria Pkwy Se Ste 100, Atlanta, GA 30339-5944 | 2017-08-30 |
| 1386195378 | Pain Management and Rehabilitation | Physical Medicine & Rehabilitation | 4121 Steve Reynolds Blvd, Norcross, GA 30093-3060 | 2016-10-14 |
| 1124471172 | Pain Management and Rehabilitation | Physical Medicine & Rehabilitation | 4131 Steve Reynolds Blvd, Norcross, GA 30093-3060 | 2016-07-14 |
| 1356761191 | Simon Matt Willis | Physical Medicine & Rehabilitation | 114 Canal St Ste 503, Pooler, GA 31322-4261 | 2014-04-20 |
| 1891139663 | Advanced Pain and Rahabilitation PC | Physical Medicine & Rehabilitation | 3030 Mcever Rd Ste 300, Gainesville, GA 30504-5538 | 2013-04-24 |
| 1013261312 | Tattnall Hospital Company, LLC | Physical Medicine & Rehabilitation | 8. North Williams Street, Metter, GA 30439 | 2012-11-08 |
| 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.