SPINE CENTER OF SOUTHEAST GEORGIA LLC - NPI 1477106771

Q: What is Spine Center Of Southeast Georgia LLC's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

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About Spine Center Of Southeast Georgia Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPINE CENTER OF SOUTHEAST GEORGIA LLC (NPI 1477106771) is a healthcare organization registered as an interventional pain medicine in Kingsland, Georgia and active in the NPI registry since July 2019. The organization holds 2 active CLIA laboratory certificates and lists Shaneka Tinch, Rcm Manager, as its authorized official.

NPPES Registry Identity

NPI1477106771

Entity TypeOrganization

Primary Taxonomy208VP0014X

Legal Business NameSPINE CENTER OF SOUTHEAST GEORGIA LLC

Location Address52A LINDSEY LANEKingsland, GA 31548-6855

Mailing Address4960 Sw 72nd Ave Ste 405Miami, FL 33155-5506 · (469) 458-9222 · Fax (540) 918-7202

Phone(912) 262-6552

Fax(912) 262-0112

Organization SubpartNo

Authorized OfficialShaneka TinchRcm Manager · (469) 458-9222

Enumeration DateJuly 17, 2019

Last NPPES UpdateDecember 8, 20254 updates tracked since enumeration

NPPES CertifiedDecember 8, 2025

✔ NPI 1477106771 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.

52A LINDSEY LANE, Kingsland, GA 31548

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

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 11D1077112

Spine Center Of Southeast Georgia, The · Brunswick, GA

Active · expires Dec 2, 2027

CLIA Number11D1077112

Laboratory TypePhysician Office

Certificate Effective DateDecember 3, 2025

Certificate Expiration DateDecember 2, 2027

Laboratory DirectorChristopher J. Bovinet

Laboratory Phone(912) 262-6552

Laboratory LocationSpine Center Of Southeast Georgia, The1111 Glynco Parkway, Suite 300, Brunswick, GA 31525

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2057970

Spine Center Of Southeast Ga - Kingsland, The · Kingsland, GA

Active · expires Apr 25, 2027

CLIA Number11D2057970

Laboratory TypePhysician Office

Certificate Effective DateApril 26, 2025

Certificate Expiration DateApril 25, 2027

Laboratory DirectorChristopher Bovinet

Laboratory Phone(912) 262-6552

Laboratory LocationSpine Center Of Southeast Ga - Kingsland, The52 A Lindsey Lane, Kingsland, GA 31548

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Spine Center Of Southeast Georgia LLC's NPI number?

The NPI number for Spine Center Of Southeast Georgia LLC is 1477106771. It was assigned to this organization in the NPPES registry on July 17, 2019.

Where is Spine Center Of Southeast Georgia LLC located?

Spine Center Of Southeast Georgia LLC is located at 52A Lindsey Lane, Kingsland, GA 31548. The listed phone number is (912) 262-6552.

What is Spine Center Of Southeast Georgia LLC's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Does Spine Center Of Southeast Georgia LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Spine Center Of Southeast Georgia LLC was last updated on December 8, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.