NPIMap

Organization Active NPI

Ortho Kinetic Spine and Rehab, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
National Provider Identifier
1104552272
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ORTHO KINETIC SPINE AND REHAB, LLC
Practice address
2000 Powers Ferry Rd SE Ste 2206
Marietta, GA 30067-1203
Phone
(470) 394-0111
Fax
(470) 443-1707
NPI assigned
Jul 29, 2022
Last updated
Jul 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Authorized official

Name
Akiliah Johnson, DCNPI 1467800110
Title
Owner
Phone
(202) 277-2255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

2000 Powers Ferry Rd SE Ste 2206
Marietta, GA 30067-1203

Mailing address

1089 Waterbury Close
Powder Springs, GA 30127-4942

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1104552272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1089 WATERBURY CLOSE",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301274942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 POWERS FERRY RD SE STE 2206",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300671203",
            "telephone_number": "470-394-0111",
            "fax_number": "470-443-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO KINETIC SPINE AND REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "AKILIAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-277-2255",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.