PCA INTERVENTIONAL SPINE AT FAYETTE, LLC
NPI 1447791074
Clinic/Center - Pain in Fayetteville, GA
NPI Status: Active since March 15, 2017
Contact Information
1233 HIGHWAY 54 W
SUITE 205
FAYETTEVILLE, GA
ZIP 30214
Phone: (404) 351-7654
- Organization
- Clinic/Center
- Pain
- Accepts Insurance
- CLIA Number: 11D2130828
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 05-17-2027
About PCA INTERVENTIONAL SPINE AT FAYETTE, LLC
This page provides the complete NPI Profile along with additional information for Pca Interventional Spine At Fayette, Llc, a provider established in Fayetteville, Georgia operating as a Clinic/center, focusing in pain . The healthcare provider is registered in the NPI registry with number 1447791074 assigned on March 2017. The practitioner's primary taxonomy code is 261QP3300X. The provider is registered as an organization and their NPI record was last updated February 2026. The authorized official of this NPI record is Dr. Rodrigo Duralde Md (Owner)
- NPI
- 1447791074
- Provider Name
- PCA INTERVENTIONAL SPINE AT FAYETTE, LLC
- Entity Type
- Organization
- Location Address
- 1233 HIGHWAY 54 W SUITE 205 FAYETTEVILLE, GA 30214
- Location Phone
- (404) 351-7654
- Mailing Address
- PO BOX 40061 BELFAST, ME 04915
- Mailing Phone
- (678) 971-4167
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-15-2017
- Last Update Date
- 02-20-2026
- Code Navigator
Location Map
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
Clinic/Center Pain
- Taxonomy Code
- 261QP3300X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | IN PROCESS (GA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
- SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
- SoloCare Gold EPO $1500 DED 10010 - EPO
- SoloCare Silver EPO $5000 DED 10014 - EPO
- SoloCare Silver EPO $6500 DED 10013 - EPO
- SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
- SoloCare Standard Gold EPO $2000 DED 10006 - EPO
- SoloCare Standard Platinum EPO $0 DED 10005 - EPO
- SoloCare Standard Silver EPO $6000 DED 10007 - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint
Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level
Injection of lower or sacral spine facet joint using imaging guidance, single level
Injection of substance into middle or upper spine canal using imaging guidance
Injection of trigger points, 1-2 muscles
Injection of upper or middle spine facet joint using imaging guidance, single level
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography
This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.
This service was performed 106 times for 68 patientsThis procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.
This service was performed 27 times for 22 patientsThis procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.
This service was performed 500 times for 228 patientsThis procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.
This service was performed 212 times for 76 patientsThis procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.
This service was performed 57 times for 40 patientsTrigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. 1-2 muscles are typically treated in one session. The procedure involves injecting medications into these points to alleviate pain.
This service was performed 18 times for 15 patientsThis procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.
This service was performed 42 times for 25 patientsThis procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.
This service was performed 224 times for 92 patientsCLIA 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
- 11D2130828
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- May 18, 2025
- Certificate Expiration Date
- May 17, 2027
- Laboratory Director
- DURALDE RODRIGO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Pca Interventional Spine At Fayette, 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 1447791074, we treat the final digit (4) 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 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
FAYETTEVILLE, GA 30214
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1447791074, enumerated as an "organization" on March 15, 2017.
The provider is located at 1233 HIGHWAY 54 W SUITE 205 FAYETTEVILLE, GA 30214 and the phone number is (404) 351-7654.
Clinic/Center with taxonomy code 261QP3300X and a focus in Pain.
The provider might be accepting Accepts: Alliant Health Plans, Inc.. Please consult your insurance carrier or call the provider to verify.
