INTERVENTIONAL PAIN SPECIALISTS OF GEORGIA LLC
NPI 1205698396
Pain Medicine - Interventional Pain Medicine in Cartersville, GA
About Interventional Pain Specialists Of Georgia Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INTERVENTIONAL PAIN SPECIALISTS OF GEORGIA LLC (NPI 1205698396) is a healthcare organization registered as an interventional pain medicine in Cartersville, Georgia and active in the NPI registry since January 2024. The organization holds a CLIA Waiver certificate valid through July 29, 2027 and lists Sackdinanh Nok Keomahathai, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Interventional Pain Specialists Of Georgia Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Interventional Pain Specialists Of Georgia LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 11D2327802
Interventional Pain Specialist Of Georgia · Cartersville, GAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Interventional Pain Specialists Of Georgia LLC's NPI number?
The NPI number for Interventional Pain Specialists Of Georgia LLC is 1205698396. It was assigned to this organization in the NPPES registry on January 25, 2024.
Where is Interventional Pain Specialists Of Georgia LLC located?
Interventional Pain Specialists Of Georgia LLC is located at 650 Henderson Dr Ste 409, Cartersville, GA 30120. The listed phone number is (470) 274-2800.
What is Interventional Pain Specialists Of Georgia LLC's specialty?
The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.
Is Interventional Pain Specialists Of Georgia LLC enrolled in Medicare?
Yes. Interventional Pain Specialists Of Georgia LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Interventional Pain Specialists Of Georgia LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Interventional Pain Specialists Of Georgia LLC, in Interventional Pain Management and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Interventional Pain Specialists Of Georgia LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2327802) is associated with this NPI, valid through July 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Interventional Pain Specialists Of Georgia LLC was last updated on June 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Interventional Pain Specialists Of Georgia Llc · NPI 1205698396
Interventional Pain Medicine organization in Cartersville, Georgia. Organization record, active in the CMS NPPES registry since January 25, 2024.
## Identity
- **NPI:** 1205698396 (Entity type: Organization)
- **Enumerated:** January 25, 2024
- **Primary specialty:** Pain Medicine - Interventional Pain Medicine · taxonomy 208VP0014X
- **Organization subpart:** No
- **Authorized official:** Sackdinanh Keomahathai, OWNER
## Practice location
- **Address:** 650 HENDERSON DR STE 409, Cartersville, GA 30120-3758
- **Phone:** (470) 274-2800 · **Fax:** (800) 501-3088
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Interventional Pain Management (1), Nurse Practitioner (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 3, 2024
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1205698396) · Data from the CMS NPPES public registry.