SOUTHERN PAIN AND SPINE ASSOCIATES, LLC – Durable Medical Equipment & Medical Supplies, NPI 1548059835

SOUTHERN PAIN AND SPINE ASSOCIATES, LLC is a healthcare provider. based in Fayetteville, Georgia. specializing in Durable Medical Equipment & Medical Supplies. The NPI Number for SOUTHERN PAIN AND SPINE ASSOCIATES, LLC is 1548059835

Main info

Organization
Name
SOUTHERN PAIN AND SPINE ASSOCIATES, LLC
NPI
1548059835
Phone
(678) 971-4167
Address
1233 HIGHWAY 54 W STE 207
Authorized Official
JOSEPHINE EVANGELISTA CREDENTIALING MANAGER
Enumeration Date
2 May 2025
Last Update Date
5 January 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience22
Completeness85
Years active:1State licenses:0Digital endpointsOther names

Provider Addresses for SOUTHERN PAIN AND SPINE ASSOCIATES, LLC

  • 1233 HIGHWAY 54 W STE 207

    FAYETTEVILLE, GA 302144643

    Phone: (678) 971-4167

    Fax: (833) 989-2501

    Type: Mailing

  • 1150 HAMMOND DR STE 50

    ATLANTA, GA 303287500

    Phone: (678) 971-4167

    Fax: (833) 989-2501

    Type: Location

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: 2025-11-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20251104001158OPhysician - Interventional Pain ManagementGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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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 30214)

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Reviews

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Frequently asked questions

What unique ID ties claims to SOUTHERN PAIN AND SPINE ASSOCIATES, LLC?
NPI 1548059835 is assigned to SOUTHERN PAIN AND SPINE ASSOCIATES, LLC under the national enumeration system.
Does this profile mean SOUTHERN PAIN AND SPINE ASSOCIATES, LLC is currently active?
Yes — SOUTHERN PAIN AND SPINE ASSOCIATES, LLC appears active in the national provider directory.
What does SOUTHERN PAIN AND SPINE ASSOCIATES, LLC treat or focus on?
Patients typically see SOUTHERN PAIN AND SPINE ASSOCIATES, LLC under the specialty Durable Medical Equipment & Medical Supplies. Clinical services aligned with this taxonomy classification.
Where is SOUTHERN PAIN AND SPINE ASSOCIATES, LLC's primary listing?
We display Fayetteville, Georgia because that is what the record indicates for SOUTHERN PAIN AND SPINE ASSOCIATES, LLC.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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