Orthopedic Surgeons of Georgia, LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

ORTHOPEDIC SURGEONS OF GEORGIA, LLC

Practice address

39 Kent Rd
Tifton, GA 31794-1698

Phone

(229) 387-8061

NPI assigned

Sep 4, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Lavonda Cravey

Title

Controller

Phone

(912) 383-5600

Specialties & licenses 1

Addresses

Other names 1

• Optim Pain Management - Tifton Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

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

• Orthopedic Surgeons of Georgia LLC

  • Orthopaedic Surgery Physician
  • Tifton, GA
  • NPI 1205115078

  O20111110000769

  Same enrollment
• Orthopedic Surgeons of Georgia LLC

  • Orthopaedic Surgery Physician
  • Valdosta, GA
  • NPI 1306125174

  O20111110000769

  Same enrollment
• Orthopedic Surgeons of Georgia LLC

  • Orthopaedic Surgery Physician
  • Douglas, GA
  • NPI 1427337294

  O20111110000769

  Same enrollment
• Orthopedic Surgeons of Georgia LLC

  • Orthopaedic Surgery Physician
  • Hazlehurst, GA
  • NPI 1780963553

  O20111110000769

  Same enrollment

Locations

Practitioners 7

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

• Stephen John Augustine, D.O.

  • Orthopaedic Surgery Physician
  • Douglas, GA
  • NPI 1538120639
  NPD
• Dewayne Calvin Dowling, NP-C

  • Family Nurse Practitioner
  • Douglas, GA
  • NPI 1720583586
  NPD
• Callie Haynes, FNP-BC

  • Family Nurse Practitioner
  • Tifton, GA
  • NPI 1003527714
  NPD
• Joshua Hughes, ANP-BC

  • Adult Health Nurse Practitioner
  • Douglas, GA
  • NPI 1538409651
  NPD
• Hewatt M Sims, MD

  • Orthopaedic Surgery of the Spine Physician
  • Douglas, GA
  • NPI 1386653061
  NPD
• Laura L Tharp, M.D.

  • Orthopaedic Surgery Physician
  • Douglas, GA
  • NPI 1437356813
  NPD
• Joshua Landon Vickers

  • Orthopaedic Surgery Physician
  • Douglas, GA
  • NPI 1871852426
  NPD

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1164857686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 KENT RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 KENT RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941698",
            "telephone_number": "229-387-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC SURGEONS OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-04",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "CRAVEY",
        "authorized_official_first_name": "LAVONDA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "912-383-5600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optim Pain Management - Tifton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• On Point Health LLC
• Open MRI of Tifton LLC
• Caylor Mark Orr, DMD
• Orthopedic and Sports Physical Therapy, Inc.
• Orthopedic Surgeons of Georgia LLC
• Thomas Judson Andrew Ott, PHARMD
• Palmetto Health Care Group LLC
• Palmetto Hospice and Palliative, LLC
• Matthew William Pantsari, M.D.
• Jeremy Paradice, MD

• Pain Clinic/Center in Tifton, GA
• Providers in Tifton, GA by specialty
• Pain Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.