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

Active since January 25, 2024CLIA 11D2327802 · Waiver
650 HENDERSON DR STE 409, CARTERSVILLE, GA 30120(470) 274-2800(800) 501-3088 Get Directions Write a Review

NPPES record last updated: June 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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

NPI1205698396
Entity TypeOrganization
Primary Taxonomy208VP0014X
Legal Business NameINTERVENTIONAL PAIN SPECIALISTS OF GEORGIA LLC
Location Address650 HENDERSON DR STE 409Cartersville, GA 30120-3758
Mailing Address650 Henderson Dr Ste 409Cartersville, GA 30120-3758
Phone(470) 274-2800
Fax(800) 501-3088
Organization SubpartNo
Authorized OfficialSackdinanh Nok KeomahathaiOwner · (470) 274-2800
Enumeration DateJanuary 25, 2024
Last NPPES UpdateJune 3, 2024
NPPES CertifiedJune 3, 2024
✔ NPI 1205698396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
Definition
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.
650 HENDERSON DR STE 409, Cartersville, GA 30120
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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, GA
Active · expires Jul 29, 2027
CLIA Number11D2327802
Laboratory TypePhysician Office
Certificate Effective DateJuly 30, 2025
Certificate Expiration DateJuly 29, 2027
Laboratory DirectorSackdinanh Nok Keomahathal
Laboratory Phone(470) 274-2800
Laboratory LocationInterventional Pain Specialist Of Georgia650 Henderson Drive, Suite 409, Cartersville, GA 30120
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SACKDINANH NOK KEOMAHATHAI MD
Pain Medicine (Interventional Pain Medicine)
650 HENDERSON DR STE 409
CARTERSVILLE, GA 30120
Bartow County (470) 274-2800
KIMBERLY ANN STALLINGS NP-C
Nurse Practitioner
650 HENDERSON DR STE 409
CARTERSVILLE, GA 30120
Bartow County (470) 274-2800
DR. KENNETH W BYERS
Internal Medicine
650 HENDERSON DR STE 409
CARTERSVILLE, GA 30120
Bartow County (770) 387-3450

Frequently 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.

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.