ORTHO SPORT & SPINE PHYSICIANS KENNESAW (NPI# 1164046132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164046132 |
| Entity Type | Organization |
| Organization Name | ORTHO SPORT & SPINE PHYSICIANS KENNESAW |
| Practice Address |
4255 Wade Green Rd Nw Kennesaw GA 30144-1762 |
| Mailing Address |
5788 Roswell Rd Atlanta GA 30328-4904 |
| Practice Telephone | 6787527246 |
| Mailing Telephone | 6787527246 |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-06-04 |
| Authorized Official Name | CHRISTOPHER W SIMS (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 6787527246 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Street Address |
4255 WADE GREEN RD NW |
| City | KENNESAW |
| State | GA |
| Zip Code | 30144-1762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073561130 | Regency Hospice of Georgia, LLC | Hospice Care, Community Based | 4255 Wade Green Rd Nw, Ste 210, Kennesaw, GA 30144-1762 | 2006-05-04 |
| 1477088185 | Rebekah Burgette | Counselor | 4255 Wade Green Rd Nw, 414, Kennesaw, GA 30144-1762 | 2017-05-01 |
| 1811383383 | Kristin Sarah Chapman | Marriage & Family Therapist | 4255 Wade Green Rd Nw, Ste. 414, Kennesaw, GA 30144-1762 | 2015-04-12 |
| 1750717096 | Valerie Brannon Aluisy | Specialist | 4255 Wade Green Rd Nw, Kennesaw, GA 30144-1762 | 2013-09-18 |
| 1205179710 | Janet Adams | Social Worker | 4255 Wade Green Rd Nw, Ste 414, Kennesaw, GA 30144-1762 | 2013-04-03 |
| 1801137690 | Elizabeth Newton | Psychologist | 4255 Wade Green Rd Nw, Ste 414, Kennesaw, GA 30144-1762 | 2013-03-05 |
| 1508120353 | Gianna G Martini-james | Social Worker | 4255 Wade Green Rd Nw, Suite414, Kennesaw, GA 30144-1762 | 2012-06-26 |
| 1932487097 | Janet Mimi Mcdonald | Counselor | 4255 Wade Green Rd Nw, Suite 414, Kennesaw, GA 30144-1762 | 2011-07-23 |
| 1730337643 | Amy Hamilton | Community/Behavioral Health | 4255 Wade Green Rd Nw, Suite 414, Kennesaw, GA 30144-1762 | 2008-09-04 |
| 1073635660 | Amedisys Georgia LLC | Home Health | 4255 Wade Green Rd Nw, Building 300, Suite 310, Kennesaw, GA 30144-1762 | 2007-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1487149340 | Creative Family Care Inc. | Social Worker | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, GA 30144 | 2018-06-24 |
| 1033632203 | Octavio Andres Tobar | Specialist/Technologist | 1950 Barrett Lakes Blvd Nw Apt 1213, Kennesaw, GA 30144 | 2017-07-19 |
| 1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
| 1073054680 | Metropolitan Health Care Plus Inc | Home Health | 445 Laurian Way, Kennesaw, GA 30144 | 2017-03-15 |
| 1649627969 | Caresouth Hha Holdings of Gainesville, LLC | Hospice Care, Community Based | 1000 Cobb Place Blvd Nw Ste 310, Kennesaw, GA 30144 | 2016-05-17 |
| 1851745988 | Joseph Mulligan | Social Worker | 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 | 2016-04-14 |
| 1629438601 | Youfit Health Clubs | Clinic/Center | 3895 Cherokee St Suite 100, Kennesaw, GA 30144 | 2016-03-03 |
| 1598156317 | Jodie Evans | Specialist | 1925 Vaughn Rd, Ste 200, Kennesaw, GA 30144 | 2015-02-16 |
| 1912302134 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Cobb Place Blvd Nw Ste 510, Kennesaw, GA 30144 | 2014-10-30 |
| Find all providers in zip 30144 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558970640 | Fx Spine and Performance Center, LLC | Clinic/Center | 106 Srp Dr Ste B, Evans, GA 30809-4358 | 2020-07-24 |
| 1083253140 | Intercare Medical, Corp | Clinic/Center | 3540 Wheeler Rd Ste 307, Augusta, GA 30909-1887 | 2020-01-06 |
| 1346763190 | Laser Spine & Pain Centers LLC | Clinic/Center | 403 Permian Way Ste C, Villa Rica, GA 30180-3252 | 2017-07-24 |
| 1164828976 | Atlanta Pain and Wellness Center PC | Clinic/Center | 1287 Ga Hwy 138 Spur Ste 8, Jonesboro, GA 30236-2419 | 2014-11-06 |
| 1790031664 | Nr Medical Center, LLC | Clinic/Center | 213 Arrowhead Blvd, Suite D, Jonesboro, GA 30236-1168 | 2012-07-30 |
| 1740566181 | Physical Medicine of Norcross | Clinic/Center | 6315 Spaulding Dr Ste B, Norcross, GA 30092-4653 | 2011-10-31 |
| 1407131899 | Cambridge Labs,llc | Clinic/Center | 611 15th St, Augusta, GA 30901-2601 | 2011-10-17 |
| 1043537905 | Primacare Pain & Rehab.,llc | Clinic/Center | 4467 Glenwood Rd, Suite 2, Decatur, GA 30032-5014 | 2010-04-30 |
| 1194994244 | Ernie E Lin | Clinic/Center | 211 Pleasant Home Road, Suite F-3, Augusta, GA 30907-0559 | 2008-02-22 |
| 1235354218 | Acworth Pain Management Center Inc | Clinic/Center | 5399 Bells Ferry Rd, Suite 180, Acworth, GA 30102-7546 | 2007-04-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ORTHO SPORT & SPINE PHYSICIANS KENNESAW.
| 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.