SELECT INTERVENTIONAL PAIN, PC
NPI 1750789947
Pain Medicine - Interventional Pain Medicine in Jackson, GA
NPI Status: Active since December 20, 2014
Contact Information
794 MCDONOUGH RD
SUITE 108
JACKSON, GA
ZIP 30233
Phone: (470) 251-5300
Fax: (470) 251-5301
- Organization
- Pain Medicine
- Interventional Pain Medicine
- Accepts Insurance
- CLIA Number: 11D2091367
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-20-2026
About SELECT INTERVENTIONAL PAIN, PC
This page provides the complete NPI Profile along with additional information for Select Interventional Pain, Pc, a provider established in Jackson, Georgia operating as a Pain Medicine, focusing in interventional pain medicine . The healthcare provider is registered in the NPI registry with number 1750789947 assigned on December 2014. The practitioner's primary taxonomy code is 208VP0014X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Derrell L Leggett Md (President)
- NPI
- 1750789947
- Provider Name
- SELECT INTERVENTIONAL PAIN, PC
- Entity Type
- Organization
- Location Address
- 794 MCDONOUGH RD SUITE 108 JACKSON, GA 30233
- Location Phone
- (470) 251-5300
- Location Fax
- (470) 251-5301
- Mailing Address
- 794 MCDONOUGH RD SUITE 108 JACKSON, GA 30233
- Mailing Phone
- (470) 251-5300
- Mailing Fax
- (470) 251-5301
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-20-2014
- Last Update Date
- 02-19-2017
- 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
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 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Complete Silver with Atrium Health - HMO
- Complete Silver with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 60125B | MEDICARE UPIN (02) | GA |
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
- 11D2091367
- Facility Type
- Physician Office
- Certificate Effective Date
- August 21, 2024
- Certificate Expiration Date
- August 20, 2026
- Laboratory Director
- LISA CICHON
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Select Interventional Pain, Pc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 5 | 0 | 7 | 8 | 9 | 9 | 4 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 14 | 8 | 18 | 9 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 1 + 4 + 8 + 1 + 8 + 9 + 8 + 24 = 73 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 73 = 7 | 7 | ||||||||
The NPI number 1750789947 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 8 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1306019104 | BENNIE R WHITE JR MD INC Organization | Clinic/Center (Primary Care) | 794 MCDONOUGH RD SUITE 105 JACKSON, GA 30233 (770) 775-2341 |
| 1093963944 | SOUTH GEORGIA TREATMENT, INC Organization | Clinic/Center (Methadone) | 794 MCDONOUGH RD JACKSON, GA 30233 (770) 775-9044 |
| 1376575225 | BENNIE R. WHITE JR. MD Individual | Family Medicine | 794 MCDONOUGH RD SUITE 105 JACKSON, GA 30233 (770) 775-2341 |
| 1306126529 | MRS. JAIMI MARIE NORRELL NP-C Individual | Nurse Practitioner (Family) | 794 MCDONOUGH RD 111 JACKSON, GA 30233 (470) 251-5300 |
| 1992943195 | DANA B BASS BURCH PA Individual | Physician Assistant (Medical) | 794 MCDONOUGH RD SUITE 111 JACKSON, GA 30233 (470) 251-5300 |
| 1033329198 | JACKSON DIALYSIS CENTER Organization | Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) | 794 MCDONOUGH RD SUITE 108 JACKSON, GA 30233 (770) 504-9525 |
| 1306025630 | DR. DERRELL LEVOHN LEGGETT M.D. Individual | Pain Medicine (Interventional Pain Medicine) | 794 MCDONOUGH RD SUITE 108 JACKSON, GA 30233 (470) 251-5300 |
| 1558330522 | RENAL TREATMENT CENTERS - MID-ATLANTIC, INC. Organization | Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) | 794 MCDONOUGH RD JACKSON, GA 30233 (770) 504-0365 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750789947, enumerated in the NPI registry as an "organization" on December 20, 2014
The provider is located at 794 Mcdonough Rd Suite 108 Jackson, Ga 30233 and the phone number is (470) 251-5300
This medical organization specializes in Pain Medicine with taxonomy code 208VP0014X with a focus in Interventional Pain Medicine
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 11D2091367 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on December 20, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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