NPIMap

Organization Active NPI

Specialty Orthopaedics, PC

  • Orthopaedic Surgery Physician
  • Dawsonville, GA
National Provider Identifier
1184380818
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SPECIALTY ORTHOPAEDICS, PC
Practice address
81 Prominence Court
Suite 100
Dawsonville, GA 30534
Phone
(770) 534-7200
NPI assigned
Nov 17, 2021
Last updated
Dec 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Authorized official

Name
Kevin Jarrard
Title
Ceo
Phone
(770) 534-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

81 Prominence Court
Suite 100
Dawsonville, GA 30534

Mailing address

1240 Jesse Jewell Pkwy SE Ste 300
Gainesville, GA 30501-3861
Phone (770) 534-7200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220215000067 GA DME Supplier - Physician - General Practice 6305805615 Practice locations: Dawsonville, GA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Specialty Orthopaedics PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1241 Friendship Rd
Ste 110
Braselton, GA 30517
Phone (470) 268-6980

5 Prominence CT Ste 100
Ste 100
Dawsonville, GA 30534

81 Prominence Ct
#100
Dawsonville, GA 30534
Phone (770) 532-7202

2320 Peachtree Industrial Blvd
Ste 103
Duluth, GA 30097
Phone (770) 532-7202

4591 Winder Hwy
Flowery Branch, GA 30542
Phone (770) 965-7210

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1184380818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013861",
            "telephone_number": "770-534-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 PROMINENCE COURT",
            "address_2": "SUITE 100",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "30534",
            "telephone_number": "770-534-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY ORTHOPAEDICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "JARRARD",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-534-7200"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.