SOUTH ATL ORTHO & SPTS (NPI# 1639368459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639368459 |
| Entity Type | Organization |
| Organization Name | SOUTH ATL ORTHO & SPTS |
| Other Organization Name | ALEXANDER N. DOMAN, MD |
| Practice Address |
425 Forest Parkway Suite 111 Forest Park GA 30297-2342 |
| Mailing Address |
425 Forest Pkwy Suite111 Forest Park GA 30297-2185 |
| Practice Telephone | 4043629935 |
| Practice Fax Number | 4043629938 |
| Mailing Telephone | 4043629935 |
| Mailing Fax Number | 4043629938 |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2009-10-02 |
| Authorized Official Name | DR. ALEXANDER NICHOLAS DOMAN (OWNER/PRESIDENT) |
| Authorized Official Telephone | 4043629935 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH ATLANTA ORTHOPEDICS & SPORTS MEDICINE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
033313 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000444881A | 05 |
| Other Name | Type Code |
|---|---|
| Alexander N. Doman, MD | Other Name - Individual/Organization |
| Street Address |
425 FOREST PARKWAY SUITE 111 |
| City | FOREST PARK |
| State | GA |
| Zip Code | 30297-2342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548747173 | Ga Peach Medical Transportation, LLC | Ambulance | 5023 Highway 85, Forest Park, GA 30297 | 2018-07-26 |
| 1871940437 | Crystal Harrison | Counselor | 4659 Ruby Ln, Forest Park, GA 30297 | 2016-05-24 |
| 1467807156 | Naundria Jackson | Nurse Practitioner | Apmc, Forest Park, GA 30297 | 2016-04-29 |
| 1891156089 | Gentle Care Medical Trans LLC | Ambulance | 530 Forest Parkway Suite B, Forest Park, GA 30297 | 2016-03-15 |
| 1811318835 | Kim Mckinney | Case Manager/Care Coordinator | 1104 South Parkwood Drive, Forest Park, GA 30297 | 2013-12-17 |
| 1215361910 | Tiffany Nadine Adams | Specialist | 228 Morrow Rd 18h, Forest Park, GA 30297 | 2013-08-29 |
| 1851663124 | Daffodil Pediatrics and Family Medicine | Pediatrics | 4905 Courtney Drive, Forest Park, GA 30297 | 2012-02-02 |
| 1093093759 | Truliant Health Systems | Community/Behavioral Health | 526 Forest Parkway Ste D, Forest Park, GA 30297 | 2011-07-29 |
| 1811134133 | Sharonda Renee Forte | Orthopaedic Surgery | 4940 Governors Park Drive, Forest Park, GA 30297 | 2009-01-08 |
| 1215173737 | Comfort Personal Care Service | Assisted Living Facility | 5530 Old Dixie Highway, D-9, Forest Park, GA 30297 | 2009-01-06 |
| Find all providers in zip 30297 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740686609 | Centro Prenatal De Georgia | Clinic/Center | 4990 Phillips Dr, Forest Park, GA 30297-1472 | 2014-11-05 |
| 1528222353 | Tapia Medical Group, Ltd | Clinic/Center | 7318 Madison St, Suite #2, Forest Park, IL 60130-3100 | 2008-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1598376865 | Deyoe Wellness | Clinic/Center | 47 Commerce Dr Ste 1b, Blairsville, GA 30512-8929 | 2020-08-11 |
| 1992331581 | World Spine and Orthopedics LLC | Clinic/Center | 4296 Memorial Dr Ste C, Decatur, GA 30032-1227 | 2020-03-16 |
| 1619517968 | Carroll Total Healthcare,pc | Clinic/Center | 410 Peachtree Pkwy Ste 4226, Cumming, GA 30041-7439 | 2020-01-14 |
| 1528601200 | Blued Consultant Solutions, LLC | Clinic/Center | 256 Rainbow Ln, Mcdonough, GA 30252-4839 | 2019-10-24 |
| 1578113585 | Centro Prenatal De Gwinnett LLC | Clinic/Center | 575 W Pike St Ste 1, Lawrenceville, GA 30046-7685 | 2019-09-12 |
| 1316508815 | Atlanta Health Clinic LLC | Clinic/Center | 2480 Windy Hill Rd Se Ste 404, Marietta, GA 30067-8658 | 2019-06-25 |
| 1659880847 | Jones Medical and Educational Consultants | Clinic/Center | 8954 Hospital Dr Bldg C, Douglasville, GA 30134-2200 | 2017-09-20 |
| 1477005593 | Hirenirali LLC | Clinic/Center | 12390 Beragio Pl, Alpharetta, GA 30004-4188 | 2016-10-25 |
| 1851840961 | Tele Doctor Direct Inc | Clinic/Center | 1250 Powers Ferry Cmn Se, Suite 100, Marietta, GA 30067-6046 | 2016-09-30 |
| 1154870533 | Life Point Medical, LLC | Clinic/Center | 189 Bo James Street, Suite 105, Clayton, GA 30525 | 2016-09-27 |
| Find all providers with the same taxonomy | ||||
| City | FOREST PARK |
| Zip Code | 30297 |
Please comment or provide details below to improve the information on SOUTH ATL ORTHO & SPTS.
| 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.