SOUTHERN PAIN AND SPINE ASSOCIATES LLC – Interventional Pain Medicine Physician, NPI 1336744770
Interventional Pain Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SOUTHERN PAIN AND SPINE ASSOCIATES LLC
1500 Oglethorpe Ave Bldg 500 Ste B
Athens, GA 306062184
Phone: (678) 971-4167
Fax: (678) 971-4168
Type: Location
3579 Highway 138 SE Ste 204
Stockbridge, GA 302816807
Phone: (678) 971-4167
Fax: (833) 428-2634
Type: Location
3231 Hwy 34E Ste C
Newnan, GA 30265
Phone: (678) 971-4167
Fax: (833) 989-2501
Type: Location
1800 Peachtree St NW Ste 750
Atlanta, GA 303092530
Phone: (678) 971-4167
Fax: (833) 428-2599
Type: Location
1233 Highway 54 W Ste 200
Fayetteville, GA 302144542
Phone: (678) 971-4167
Fax: (833) 428-2629
Type: Location
1150 Hammond Drive
Bldg E, Suite 40
Atlanta, GA 30328
Phone: (678) 971-4167
Fax: (833) 972-4825
Type: Location
1101 Old Philadelphia Rd Ste G100
Jasper, GA 301434044
Phone: (678) 971-4167
Fax: (706) 253-7060
Type: Location
601 BROAD ST SE STE B
GAINESVILLE, GA 305013718
Phone: (678) 971-4167
Fax: (678) 971-4168
Type: Mailing
1233 HIGHWAY 54 W STE 200
FAYETTEVILLE, GA 302144542
Phone: (678) 971-4167
Fax: (883) 428-2629
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-01-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-01-31 (129 days ago).
Enrollment records
1
Earliest due date
2026-01-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20210120000336 | O | Clinic/Group Practice | GA | 2026-01-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30606)
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