Organization Active NPI

Orthoatlanta Surgery Center of Austell, LLC

  • Ambulatory Surgical Clinic/Center
  • Austell, GA
National Provider Identifier
1053632372
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ORTHOATLANTA SURGERY CENTER OF AUSTELL, LLC
Practice address
3672 Marathon Circle
Suite 120
Austell, GA 30106-6821
Phone
(678) 945-8551
Fax
(678) 945-8549
NPI assigned
Jun 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Authorized official

Name
Ms. Linda Terhark
Title
Administrator
Phone
(678) 945-8551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3672 Marathon Circle
Suite 120
Austell, GA 30106-6821

Mailing address

3672 Marathon Circle
Suite 120
Austell, GA 30106-6821
Phone (678) 945-8551

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110208000199 GA Part B Supplier - Ambulatory Surgical Center 9436339587 Practice locations: Austell, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Orthoatlanta Surgery Center of Austell LLCCCN 11C0001362
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2009996Orthoatlanta Surgery Center Austell, LLC3672 Marathon Circle, Suite 120, Austell, GA 30106Certificate of waiverJul 18, 2026

National Provider Directory

National Provider Directory

Locations

3672 Marathon Cir
#120
Austell, GA 30106
Phone (678) 945-8551

Practitioners & affiliated clinicians

Practitioners 2

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": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1053632372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3672 MARATHON CIRCLE",
            "address_2": "SUITE 120",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066821",
            "telephone_number": "678-945-8551",
            "fax_number": "678-945-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3672 MARATHON CIRCLE",
            "address_2": "SUITE 120",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066821",
            "telephone_number": "678-945-8551",
            "fax_number": "678-945-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOATLANTA SURGERY CENTER OF AUSTELL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "TERHARK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-945-8551",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.