SPINE AND ORTHOPEDICS OF ATLANTA, LLC (NPI# 1265802318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265802318 |
Entity Type | Organization |
Organization Name | SPINE AND ORTHOPEDICS OF ATLANTA, LLC |
Practice Address |
1462 Montreal Rd Ste 218 Tucker GA 30084 |
Mailing Address |
1462 Montreal Rd Ste 218 Tucker GA 30084-6931 |
Practice Telephone | 4702940863 |
Practice Fax Number | 4702940889 |
Enumeration Date | 2015-10-01 |
Last Update Date | 2018-09-06 |
Authorized Official Name | DR. DAMIEN DOUTE (OWNER/PHYSICIAN) |
Authorized Official Telephone | 4704405848 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 728513163A | 05 |
Street Address |
1462 MONTREAL RD STE 218 |
City | TUCKER |
State | GA |
Zip Code | 30084 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609401355 | Excellent Medical Transport | Ambulance | 4378 Sentry Dr, Tucker, GA 30084 | 2020-03-03 |
1811468796 | Caleb Lee Ebbets | Physical Therapist | 1459 Montreal Road, Medical Office Building, Suite 301, Tucker, GA 30084 | 2018-12-17 |
1417436130 | Benjamin Han Wook Chong | Physical Therapist | 1460 Montreal Road East, Suite 300, Tucker, GA 30084 | 2018-08-13 |
1336659325 | Lavista Acupuncture and Herbal Medicine | Acupuncturist | 4915 Lavista Rd, Tucker, GA 30084 | 2017-10-04 |
1699294207 | Debrica Butler | Counselor | 1021 Oak Chase Dr., Apt C, Tucker, GA 30084 | 2017-09-14 |
1295264695 | Jolanta Wazgowska Hopkins | Social Worker | 4404 Idlewood Lane, Tucker, GA 30084 | 2017-06-08 |
1164956157 | Sage Dental Group of Georgia LLC | Dentist | 4320 Lavista Rd, Suite C119, Tucker, GA 30084 | 2017-04-17 |
1689107807 | Mashail Manzur | Podiatrist | 1460 Montreal Rd E, Ste 275, Tucker, GA 30084 | 2017-04-05 |
1053765578 | Jessica Spruyt | Speech-Language Pathologist | 3756 Lavista Rd Suite 104, Tucker, GA 30084 | 2016-04-21 |
1396114674 | Ashley Carrigan | Behavioral Analyst | 3786 Lavista Road, Suite 104, Tucker, GA 30084 | 2015-09-17 |
Find all providers in zip 30084 |
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 |
---|---|---|---|---|
1710286414 | Northlake Internal Medicine | Clinic/Center | 2175 Northlake Pkwy, St 142,bldg 4, Tucker, GA 30084-4163 | 2011-03-21 |
1962695866 | Atlanta Gyn Center | Clinic/Center | 1922 Northlake Pkwy, Tucker, GA 30084-7009 | 2007-08-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
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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.