NPIMap

Organization Active NPI

Hospital Authority of Liberty County

Doing business as Liberty Regional Orthopaedics

  • Orthopaedic Surgery Physician
  • Hinesville, GA
National Provider Identifier
1023443801
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
HOSPITAL AUTHORITY OF LIBERTY COUNTY
Doing business as
Liberty Regional Orthopaedics
Practice address
455 S Main St Ste 205
Hinesville, GA 31313-4354
Phone
(912) 369-9400
Fax
(912) 877-9438
NPI assigned
Sep 11, 2013
Last updated
Jul 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
HOSPITAL AUTHORITY OF LIBERTY COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Derek Rozier
Title
Cfo
Phone
(912) 369-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

455 S Main St Ste 205
Hinesville, GA 31313-4354

Mailing address

455 S Main St Ste 205
Hinesville, GA 31313-4354
Phone (912) 369-9400

Other names 1

  • Liberty Regional Orthopaedics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040428000377 GA Part B Supplier - Clinic/Group Practice 5799772190 Receives reassigned benefits from 26 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hinesville, GA; Ludowici, GA; Midway, GA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Liberty Memorial Hospit9 organizations share this tax ID, including this one
Part of
Liberty Memorial Hospit

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

462 Elma G Miles Pkwy
Hinesville, GA 31313
Phone (888) 829-0068

73 Coastal Manor Dr SE
Ludowici, GA 31316
Phone (912) 369-9313

Networks

  • SC HMO

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1023443801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST STE 205",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134354",
            "telephone_number": "912-369-9400",
            "fax_number": "912-877-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S MAIN ST STE 205",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134354",
            "telephone_number": "912-369-9400",
            "fax_number": "912-877-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF LIBERTY COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL AUTHORITY OF LIBERTY COUNTY",
        "enumeration_date": "2013-09-11",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "ROZIER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-369-9400"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Regional Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hinesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.