Sackdinanh N Keomahathai (NPI# 1083775670, PAC ID# 6002867447) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1083775670 |
| PAC ID by PECOS | 6002867447 |
| Professional Enrollment ID | I20050203000156 |
| Full Name | Sackdinanh N Keomahathai |
| Organization Legal Name | INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC |
| Address |
1388 Wellbrook Necir A Conyers GA 30012-3872 |
| Phone Number | 7709299033 |
| Gender | M |
| Credential | MD |
| Medical School | MEDICAL COLLEGE OF VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1996 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 2769483031 |
| Number of Group Practice Members | 46 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110042 | WELLSTAR PAULDING HOSPITAL |
| 110035 | WELLSTAR KENNESTONE HOSPITAL |
| 111330 | POLK MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1388 Wellbrook Necir A, Conyers, GA 30012-3872 | 7709299033 | INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | INTERVENTIONAL SPINE AND PAIN MANAGEMENT CENTER, PC |
| Physicians | 48 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kunwal Molwani | Nurse Practitioner | Interventional Spine and Pain Management Center, PC | 1367 Interstate Pkwy, Augusta, GA 30909-5626 |
| Torre S Massey | Nurse Practitioner | Interventional Spine and Pain Management Center, PC | 6002 Hwy 53 E 110, Dawsonville, GA 30534 |
| Rhee W Miller | Interventional Pain Management | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Pallavi Gupta | Pain Management | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Preeti Narayan | Anesthesiology | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Preetesh P Patel | Anesthesiology | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Rachel Eicher | Physician Assistant | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Kelly Mcdowell | Nurse Practitioner | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Beata K Grochowska | Pain Management | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Robin J Fowler | Interventional Pain Management | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Street Address |
1388 WELLBROOK NECIR A |
| City | CONYERS |
| State | GA |
| Zip | 30012-3872 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rhee W Miller | Interventional Pain Management | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Pallavi Gupta | Pain Management | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Preeti Narayan | Anesthesiology | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Preetesh P Patel | Anesthesiology | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Rachel Eicher | Physician Assistant | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Kelly Mcdowell | Nurse Practitioner | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Beata K Grochowska | Pain Management | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Robin J Fowler | Interventional Pain Management | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Efosa Ogiamien | Anesthesiology | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Juan He | Physician Assistant | Interventional Spine and Pain Management Center, PC | 1388 Wellbrook Necir A, Conyers, GA 30012-3872 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven T Wilder | Chiropractic | 1091 W Ave Sw, Conyers, GA 30012 | |
| Sitharam Chowdary Nandigam | Nephrology | Eastside Premier Nephrology and Hypertension PC | 1612 Milstead Rd, Suite A, Conyers, GA 30012-3738 |
| Ekundayo A Falase | Nephrology | Eastside Premier Nephrology and Hypertension PC | 1612 Milstead Rd, Suite A, Conyers, GA 30012-3738 |
| Yilikal Tassew Kassa | Nephrology | Eastside Premier Nephrology and Hypertension PC | 1612 Milstead Rd, Suite A, Conyers, GA 30012-3738 |
| Nardos Ketema Belayneh | Nephrology | Eastside Premier Nephrology and Hypertension PC | 1612 Milstead Rd, Suite A, Conyers, GA 30012-3738 |
| Neil A Trossevin | Physician Assistant | Georgia Urology, Pa | 1301 Sigman Rd Ne, Suite 250a, Conyers, GA 30012-3812 |
| Allen A Futral | Urology | Georgia Urology, Pa | 1301 Sigman Rd Ne, Suite 250a, Conyers, GA 30012-3812 |
| Bert T Chen | Urology | Georgia Urology, Pa | 1301 Sigman Rd Ne, Suite 250a, Conyers, GA 30012-3812 |
| Froylan C Gonzales | Urology | Georgia Urology, Pa | 1301 Sigman Rd Ne, Suite 250a, Conyers, GA 30012-3812 |
| Kisha Adderley | Nurse Practitioner | Rockdale Physician Practices LLC | 1301 Sigman Rd Ne, Suite 125, Conyers, GA 30012-3812 |
| Find all physicians in zip 30012 | |||
| City | CONYERS |
| Zip Code | 30012 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | CONYERS + PHYSICAL MEDICINE AND REHABILITATION |
Please comment or provide details below to improve the information on Sackdinanh N Keomahathai.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.