NPIMap

Organization Active NPI

Peachtree Orthopaedic Clinic of Georgia, LLC

Doing business as Peachtree Orthopedics at Braselton

  • Orthopaedic Surgery Physician
  • Braselton, GA
National Provider Identifier
1033943105
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PEACHTREE ORTHOPAEDIC CLINIC OF GEORGIA, LLC
Doing business as
Peachtree Orthopedics at Braselton
Practice address
1524 River PL Ste 200
Braselton, GA 30517-5614
Phone
(404) 355-0743
Fax
(833) 450-5581
NPI assigned
Aug 29, 2024
Last updated
Mar 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Authorized official

Name
Joi M King
Title
Rev Cycle Leader
Phone
(215) 873-4811

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
Orthopaedic Surgery Physician 207X00000X NU Primary
Orthopaedic Hand Surgery Physician 207XS0106X NU
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X NU
Orthopaedic Surgery of the Spine Physician 207XS0117X NU
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X NU
Orthopaedic Trauma Physician 207XX0801X NU
Pediatric Orthopaedic Surgery Physician 207XP3100X NU

Addresses

Primary practice location

1524 River PL Ste 200
Braselton, GA 30517-5614

Mailing address

3200 Downwood Cir NW FL 7
Atlanta, GA 30327-1610
Phone (215) 873-4811

Other practice location 1

3200 Downwood Cir NW Fl 7
Atlanta, GA 30327-1610
Phone (404) 355-0743

Other names 2

  • Peachtree Orthopedics at Braselton Doing business as
  • Peachtree Orthopaedic Clinic at Braselton, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250108002194 GA Part B Supplier - Clinic/Group Practice 3072041748 Receives reassigned benefits from 9 practitioners
Practice locations: Braselton, GA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1000 Northside Dr NW
Ste 1500
Atlanta, GA 30318
Phone (404) 350-2446

2001 Peachtree Rd NE
Ste 705
Atlanta, GA 30309

3200 Downwood Cir NW
Fl 7
Atlanta, GA 30327

3200 Downwood Cir NW
Ste 700
Atlanta, GA 30327
Phone (404) 355-8066

1524 River Pl
Ste 200
Braselton, GA 30517

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774224000000",
    "number": "1033943105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 DOWNWOOD CIR NW FL 7",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303271610",
            "telephone_number": "215-873-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 RIVER PL STE 200",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305175614",
            "telephone_number": "404-355-0743",
            "fax_number": "833-450-5581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Downwood Cir NW Fl 7",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303271610",
            "country_code": "US",
            "telephone_number": "404-355-0743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEACHTREE ORTHOPAEDIC CLINIC OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JOI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "REV CYCLE LEADER",
        "authorized_official_telephone_number": "215-873-4811"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree Orthopedics at Braselton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peachtree Orthopaedic Clinic at Braselton, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Braselton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.