GEORGIA COMPLEX SPINE, LLC (NPI# 1083165252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083165252 |
| Entity Type | Organization |
| Organization Name | GEORGIA COMPLEX SPINE, LLC |
| Practice Address |
1368 Southlake Plaza Dr Morrow GA 30260-1756 |
| Mailing Address |
4920 Atlanta Hwy #134 Alpharetta GA 30004-2921 |
| Practice Telephone | 6787672569 |
| Practice Fax Number | 6785509990 |
| Mailing Telephone | 6787672569 |
| Mailing Fax Number | 6785509990 |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2016-10-21 |
| Authorized Official Name | DR. STEPHEN BRUCE JAMES (ORTHOPAEDIC SPINE SURGEON) |
| Authorized Official Telephone | 6785217064 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
50385 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI | 1013904697 | 01 | |
| GA | 000911919 | 05 |
| Street Address |
1368 SOUTHLAKE PLAZA DR |
| City | MORROW |
| State | GA |
| Zip Code | 30260-1756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346543212 | Clement A Ncho | Physician Assistant | 1368 Southlake Plaza Dr, Morrow, GA 30260-1756 | 2010-12-14 |
| 1154703478 | Regional Occupational Medicine LLC | Internal Medicine | 1368 Southlake Plaza Dr, Morrow, GA 30260-1756 | 2015-06-23 |
| 1851687669 | Tyler B Young | Physical Therapist | 1368 Southlake Plaza Dr, Morrow, GA 30260-1756 | 2011-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766605 | C. Alexander Pediatrics LLC | Emergency Medicine | 2180 Rex Road, Morrow, GA 30260 | 2020-10-02 |
| 1578127627 | Osara Dhevmi Malalasekara | Student in an Organized Health Care Education/Training Program | Amc Family Medicine Residency Program, 1000 Corporate Center Dr Suite 200, Morrow, GA 30260 | 2019-04-24 |
| 1902360860 | Katrina Samuels | Technician | 5771 Trammell Rd. Morrow Ga, Morrow, GA 30260 | 2019-01-24 |
| 1679067870 | Atl Sport | Community/Behavioral Health | 5376 Jonesboro Rd, Lake City, GA 30260 | 2018-06-20 |
| 1487184099 | Mamie Rochell Jinks | Driver | 1541 Lakeland Cir, Lake City, GA 30260 | 2017-06-15 |
| 1598202079 | Grace Misi Nteff | Nurse Practitioner | 1000 Clayton Village, Clayton State University, School of Nursing Community, Morrow, GA 30260 | 2017-01-23 |
| 1902357908 | Morrow Family Dentistry, P.C. | Clinic/Center | 6319a Jonesboro Road, Morrow, GA 30260 | 2016-10-14 |
| 1043679418 | Elite Rehab and Weightloss | Chiropractor | 1568 Southlake Pkwy Ste C, Morrow, GA 30260 | 2016-02-15 |
| 1659758985 | Clayton State University | Nurse Practitioner | 5809 Northlake Drive, Bldg 1000, Morrow, GA 30260 | 2015-05-06 |
| 1255731519 | Care First Private Home Care | In Home Supportive Care | 2380 Fairfield Court, Morrow, GA 30260 | 2014-08-23 |
| Find all providers in zip 30260 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184122962 | Spine Cin of Atlanta LLC | Orthopaedic Surgery | 10 Glenlake Pkwy Ste 130a, Atlanta, GA 30328-3495 | 2018-01-26 |
| 1295243061 | Joint Replacement Cin of Atlanta LLC | Orthopaedic Surgery | 10 Glenlake Pkwy # 130b, Atlanta, GA 30328-3495 | 2018-01-16 |
| 1124568480 | Macon Orthopaedic & Hand Center, Pa | Orthopaedic Surgery | 109 Fairview Park Dr, Dublin, GA 31021-2562 | 2017-03-06 |
| 1588056873 | Spinecentersavannah, LLC | Orthopaedic Surgery | 1266 W Paces Ferry Rd Nw, Box 437, Atlanta, GA 30327-2306 | 2015-02-24 |
| 1811134133 | Sharonda Renee Forte | Orthopaedic Surgery | 4940 Governors Park Drive, Forest Park, GA 30297 | 2009-01-08 |
| 1851455877 | Plas T James | Orthopaedic Surgery | 3200 Downwood Cir Nw Ste 500, Atlanta, GA 30327-1659 | 2006-12-21 |
| 1376602565 | Premier Orthopaedic Surgery, LLC | Orthopaedic Surgery | 7360 Mcginnis Ferry Rd, Suite E, Suwanee, GA 30024-6603 | 2006-12-06 |
| 1992810105 | Sangwook Tim Yoon | Orthopaedic Surgery | 59 Executive Park South Ne Ste 3000, Atlanta, GA 30329-2208 | 2006-08-20 |
| 1295745081 | Andrew G Cordista | Orthopaedic Surgery | 8 Live Oak Ct, Moultrie, GA 31768-6783 | 2006-08-08 |
| 1952376337 | Todd C Bonvallet | Orthopaedic Surgery | 6262 Veterans Pkwy, Columbus, GA 31909-3540 | 2006-02-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.