NPIMap

Organization Active NPI

Georgia Sports Medicine and Orthopedic Clinic, PC

  • Orthopaedic Surgery Physician
  • Tifton, GA
National Provider Identifier
1023217171
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
GEORGIA SPORTS MEDICINE AND ORTHOPEDIC CLINIC, PC
Practice address
1610 John Orr Dr
Suite a
Tifton, GA 31794-3682
Phone
(229) 386-5222
Fax
(229) 382-6191
NPI assigned
Jul 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Drew Dorminey
Title
Administrator/Coo
Phone
(229) 387-1185

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1610 John Orr Dr
Suite a
Tifton, GA 31794-3682

Mailing address

PO Box 7630
Tifton, GA 31793-7630
Phone (229) 386-5222

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1023217171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7630",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317937630",
            "telephone_number": "229-386-5222",
            "fax_number": "229-382-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 JOHN ORR DR",
            "address_2": "SUITE A",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943682",
            "telephone_number": "229-386-5222",
            "fax_number": "229-382-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA SPORTS MEDICINE AND ORTHOPEDIC CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "DORMINEY",
        "authorized_official_first_name": "DREW",
        "authorized_official_title_or_position": "ADMINISTRATOR/COO",
        "authorized_official_telephone_number": "229-387-1185",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.