DR. NICOLAS SIMON BONNAIG (NPI# 1609038207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609038207 |
| Entity Type | Individual |
| Full Name | DR. NICOLAS SIMON BONNAIG |
| Credential | M.D. |
| Practice Address |
300 Tower Rd Ne Suite 200 Marietta GA 30060-9404 |
| Practice Telephone | 7704275717 |
| Practice Fax Number | 7705145040 |
| Mailing Telephone | 7704275717 |
| Mailing Fax Number | 7705145040 |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2014-12-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
071318 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
300 TOWER RD NE SUITE 200 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-9404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578566527 | Stanley H Dysart | Orthopaedic Surgery | 300 Tower Rd Ne, Ste 200, Marietta, GA 30060-9403 | 2005-05-23 |
| 1023559135 | Adam Colon | Specialist/Technologist | 300 Tower Rd Ne, 200, Marietta, GA 30060-9404 | 2017-03-09 |
| 1003367707 | Pinnacle Orthopaedics & Sports Medicine Specialists LLC | Specialist | 300 Tower Rd Ne, Suite 100, Marietta, GA 30060-9404 | 2016-10-18 |
| 1023565199 | Derek Austin Dubois | Nurse Practitioner | 300 Tower Rd Ne, Suite 200, Marietta, GA 30060-9404 | 2016-09-07 |
| 1861841264 | Kadesha Massaud | Nurse Practitioner | 300 Tower Rd Ne, Suite 200, Marietta, GA 30060-9404 | 2016-06-07 |
| 1164888582 | Julianna Hartzel | Physical Therapist | 300 Tower Rd Ne, Suite100, Marietta, GA 30060-9404 | 2016-01-14 |
| 1730577172 | Pinnacle Orthopaedics | Specialist | 300 Tower Rd Ne, Suite 200, Marietta, GA 30060-9404 | 2015-01-08 |
| 1902213853 | Jeremy Daniel Melton | Physician Assistant | 300 Tower Rd Ne, Suite 200, Marietta, GA 30060-9404 | 2014-07-11 |
| 1235540659 | Aaron T. Richardson | Physical Therapist | 300 Tower Rd Ne, Suite 100, Marietta, GA 30060-9404 | 2014-05-20 |
| 1629395140 | Michelle Ann Ray | Physician Assistant | 300 Tower Rd Ne, Suite 200, Marietta, GA 30060-9404 | 2010-04-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
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| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497791388 | Devola Orthopedic Center of Sports Medicine, Inc. | Orthopaedic Surgery | 4800 State Route 60, Marietta, OH 45750-5432 | 2006-06-21 |
| 1578566147 | William D Terrell | Orthopaedic Surgery | 300 Tower Rd Ne, Ste 200, Marietta, GA 30060-9403 | 2005-05-27 |
| 1457354151 | Michael L Kuczmanski | Orthopaedic Surgery | 300 Tower Rd Ne, Ste 200, Marietta, GA 30060-9403 | 2005-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326679671 | Barbour Orthopaedics & Sports Medicine PC | Orthopaedic Surgery | 965 Oakland Rd Ste C, Lawrenceville, GA 30044-3758 | 2020-01-27 |
| 1932730298 | Barbour Orthopaedics & Sports Medicine PC | Orthopaedic Surgery | 1100 Northside Forsyth Dr Ste 360, Cumming, GA 30041-6022 | 2020-01-27 |
| 1275094310 | Mariolino Da Graca Fernandes | Orthopaedic Surgery | 3240 Northeast Expy Ne, Atlanta, GA 30341-4003 | 2019-03-29 |
| 1437601598 | Optim Orthopedics LLC | Orthopaedic Surgery | 460 Mall Blvd Ste B, Savannah, GA 31406-4801 | 2016-10-25 |
| 1750753182 | Zachary Russell | Orthopaedic Surgery | 1305 Jennings Mill Road, Building 300, Suite 110, Watkinsville, GA 30677 | 2015-10-26 |
| 1396121315 | 2 Bare Bones Medical LLC | Orthopaedic Surgery | 11102 Abercorn St, Savannah, GA 31419-1822 | 2015-07-31 |
| 1578985180 | Brandon Dobo | Orthopaedic Surgery | 410 Brookhaven Way Ne, Atlanta, GA 30319-3177 | 2014-01-16 |
| 1306102785 | Elan J Golan | Orthopaedic Surgery | 1800 Tree Ln Ste 140, Snellville, GA 30078-6799 | 2012-04-10 |
| 1235405747 | Pinnacle Orthopaedics & Sports Medicine Specia | Orthopaedic Surgery | 1000 Chastain Road, Building II, Kennesaw, GA 30144-0000 | 2012-03-29 |
| 1346413648 | Mathew William Pombo | Orthopaedic Surgery | 3855 Pleasant Hill Rd Ste 470, Duluth, GA 30096-1417 | 2008-04-08 |
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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.