SOUTH GA SPINE CARE INSTITUTE (NPI# 1437299740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437299740 |
| Entity Type | Organization |
| Organization Name | SOUTH GA SPINE CARE INSTITUTE |
| Practice Address |
8 Live Oak Ct Moultrie GA 31768-6783 |
| Practice Telephone | 2298906612 |
| Practice Fax Number | 2298906621 |
| Mailing Telephone | 2298906612 |
| Mailing Fax Number | 2298906621 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2015-12-16 |
| Authorized Official Name | ANDREW GREGORY CORDISTA (DOCTOR) |
| Authorized Official Telephone | 2298906612 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
051451 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000921522B | 05 |
| Street Address |
8 LIVE OAK CT |
| City | MOULTRIE |
| State | GA |
| Zip Code | 31768-6783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295745081 | Andrew G Cordista | Orthopaedic Surgery | 8 Live Oak Ct, Moultrie, GA 31768-6783 | 2006-08-08 |
| 1639570328 | Colquitt Regional Spine LLC | Orthopaedic Surgery | 8 Live Oak Ct, Moultrie, GA 31768-6783 | 2014-09-12 |
| 1558594663 | Hanger Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 8 Live Oak Ct, Moultrie, GA 31768-6783 | 2009-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975452 | Zachary Schiffer | Specialist/Technologist | 3131 S Main Street, Moultrie, GA 31768 | 2020-02-27 |
| 1326697731 | Daisy Concierge Care | Nursing Care | 437 S. Morris Rd Lt 1, Moultrie, GA 31768 | 2019-09-09 |
| 1194208751 | Regina Mercer Ward | Nurse Practitioner | 1724 Villa Dr Sw, Moultrie, GA 31768 | 2018-09-10 |
| 1225473630 | Moultrie Orthodontics, P.C. | Clinic/Center | 12 Longleaf Office Park, Moultrie, GA 31768 | 2013-04-30 |
| 1497032239 | Freds Stores of Tennessee Inc | Pharmacy | 2601 South Main Street, Moultrie, GA 31768 | 2011-11-08 |
| 1821382672 | Colquitt Regional Ob/gyn, LLC | Obstetrics & Gynecology | 3 Sweet Bay Ct, Moultrie, GA 31768 | 2011-06-08 |
| 1568779809 | Shana Goodno | Nurse Practitioner | 207 31 St Ave Se, Moultrie, GA 31768 | 2010-09-08 |
| 1508177445 | Cherokee Rose Emergency Physicians | Emergency Medicine | 3131 South Main Street, Moultrie, GA 31768 | 2010-06-25 |
| 1023299963 | Hetal Patel | Counselor | 600 2nd St South East, Moultrie, GA 31768 | 2007-11-20 |
| 1720146756 | William C Byrd Inc | Assisted Living Facility | 498 5th Street Se, Moultrie, GA 31768 | 2006-12-04 |
| Find all providers in zip 31768 | ||||
| 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 |
|---|---|---|---|---|
| 1295745081 | Andrew G Cordista | Orthopaedic Surgery | 8 Live Oak Ct, Moultrie, GA 31768-6783 | 2006-08-08 |
| 1639570328 | Colquitt Regional Spine LLC | Orthopaedic Surgery | 8 Live Oak Ct, Moultrie, GA 31768-6783 | 2014-09-12 |
| 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 |
| 1952376337 | Todd C Bonvallet | Orthopaedic Surgery | 6262 Veterans Pkwy, Columbus, GA 31909-3540 | 2006-02-21 |
| 1013904697 | Stephen B. James | Orthopaedic Surgery | 4920 Atlanta Hwy, #134, Alpharetta, GA 30004-2921 | 2005-09-29 |
| 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.