ORTHO ATLANTA SURGERY CENTER OF FAYETTEVILLE (NPI# 1447630876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447630876 |
| Entity Type | Organization |
| Organization Name | ORTHO ATLANTA SURGERY CENTER OF FAYETTEVILLE |
| Practice Address |
1265 Highway 54 W Ste 103 Fayetteville GA 30214-4537 |
| Practice Telephone | 6786735108 |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2015-06-01 |
| Authorized Official Name | BRIAN YOUNG (ADMINISTRATOR) |
| Authorized Official Telephone | 6786735108 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
056-HOS-001 | GA | Ambulatory Health Care Facilities |
| Street Address |
1265 HIGHWAY 54 W STE 103 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-4537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477178879 | Surgcenter of Fayetteville, LLC | Clinic/Center | 1905 E Mission Blvd Ste 5, Fayetteville, AR 72703-3129 | 2020-06-11 |
| 1750905618 | Rsps Fayetteville Asc Lllp | Clinic/Center | 874 Lanier Ave W Ste 270, Fayetteville, GA 30214-7617 | 2020-06-05 |
| 1396298139 | Resurgens Fayette Surgery Center, LLC | Clinic/Center | 1336 Highway 54 W Bldg 400, Fayetteville, GA 30214-4535 | 2016-07-28 |
| 1801196050 | Agcny East LLC | Clinic/Center | Northeast Medical Building Condominium, Suite 308, Fayetteville, NY 13066-6638 | 2010-10-21 |
| 1265679674 | Georgia Urology Fayette Asc | Clinic/Center | 140 Carnegie Pl, Suite 108, Fayetteville, GA 30214-7913 | 2009-01-07 |
| 1093907339 | Taylor Surgery Center, LLC | Clinic/Center | 3733 N Business Dr Ste 101, Fayetteville, AR 72703-5286 | 2007-08-10 |
| 1386737021 | Arkansas Outpatient Eye Surgery LLC | Clinic/Center | 3689 N Steele Blvd, Fayetteville, AR 72703-5347 | 2006-10-02 |
| 1033154364 | Paula Pons Physician LLC | Clinic/Center | 4206 Medical Center Dr Ste 203, Fayetteville, NY 13066 | 2006-06-19 |
| 1285622845 | Physicians' Surgery Center of Fayetteville, LLC | Clinic/Center | 3733 N Business Dr, Suite #101, Fayetteville, AR 72703-5203 | 2005-10-07 |
| 1447791074 | Pca Interventional Spine At Fayette, LLC | Clinic/Center | 1233 Highway 54 W, Suite 205, Fayetteville, GA 30214-4542 | 2017-03-15 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on ORTHO ATLANTA SURGERY CENTER OF FAYETTEVILLE.
| 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.