INTERVENTIONAL PAIN SPECIALISTS OF GEORGIA LLC
NPI 1205698396
Pain Medicine - Interventional Pain Medicine in Cartersville, GA

NPI Status: Active since January 25, 2024

Contact Information

650 HENDERSON DR STE 409
CARTERSVILLE, GA
ZIP 30120
Phone: (470) 274-2800
Fax: (800) 501-3088

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  • Organization
  • Pain Medicine
  • Interventional Pain Medicine
  • CLIA Number: 11D2327802
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 07-29-2027

About INTERVENTIONAL PAIN SPECIALISTS OF GEORGIA LLC

This page provides the complete NPI Profile along with additional information for Interventional Pain Specialists Of Georgia Llc, a provider established in Cartersville, Georgia operating as a Pain Medicine, focusing in interventional pain medicine . The healthcare provider is registered in the NPI registry with number 1205698396 assigned on January 2024. The practitioner's primary taxonomy code is 208VP0014X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Interventional Pain Specialists Of Georgia Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Sackdinanh Nok Keomahathai Md (Owner)

NPI
1205698396
Provider Name
INTERVENTIONAL PAIN SPECIALISTS OF GEORGIA LLC
Entity Type
Organization
Location Address
650 HENDERSON DR STE 409 CARTERSVILLE, GA 30120
Location Phone
(470) 274-2800
Location Fax
(800) 501-3088
Mailing Address
650 HENDERSON DR STE 409 CARTERSVILLE, GA 30120
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-25-2024
Last Update Date
06-03-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pain Medicine Interventional Pain Medicine

Taxonomy Code
208VP0014X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SACKDINANH NOK KEOMAHATHAI MD

Authorized Official Title
OWNER
Authorized Official Phone
(470) 274-2800

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
11D2327802
Facility Type
Physician Office
Certificate Effective Date
July 30, 2025
Certificate Expiration Date
July 29, 2027
Laboratory Director
SACKDINANH NOK KEOMAHATHAL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Interventional Pain Specialists Of Georgia Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1205698396, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
0
Doubled → 0
Pos 4
5
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
9
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
3
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 6 → 12 → 3 8 → 16 → 7 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 0 + 5 + 1 + 2 + 9 + 1 + 6 + 3 + 1 + 8 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1205698396.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Internal Medicine
650 HENDERSON DR STE 409
CARTERSVILLE, GA 30120
Pain Medicine (Interventional Pain Medicine)
650 HENDERSON DR STE 409
CARTERSVILLE, GA 30120
Nurse Practitioner
650 HENDERSON DR STE 409
CARTERSVILLE, GA 30120

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205698396, enumerated as an "organization" on January 25, 2024.

The provider is located at 650 HENDERSON DR STE 409 CARTERSVILLE, GA 30120 and the phone number is (470) 274-2800.

Pain Medicine with taxonomy code 208VP0014X and a focus in Interventional Pain Medicine.