Active NPI
Athens Orthopedic Clinic Ambulatory Surgery Center-Loganville, LLC
- Ambulatory Surgical Clinic/Center
- Loganville, GA
National Provider Identifier
1235677808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER-LOGANVILLE, LLC
- Practice address
- 3440 Highway 81
Ste 100
Loganville, GA 30052-9112 - Phone
- (706) 549-1663
- NPI assigned
- Feb 3, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Boblitz
- Title
- Ceo
- Phone
- (706) 433-3120
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
3440 Highway 81
Ste 100
Loganville, GA 30052-9112
Mailing address
3440 Highway 81
Ste 100
Loganville, GA 30052-9112
Phone (706) 549-1663
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170801001304 | GA | Part B Supplier - Ambulatory Surgical Center | 9931470580 | Practice locations: Loganville, GA |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Athens Orthopedic Clinic Ambulatory Surgery Center Loganville LLC
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
3440 Highway 81
Ste 100
Loganville, GA 30052
Phone (706) 227-3450
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Athens, GA
- NPI 1194846097
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486080000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1749513600000",
"number": "1235677808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3440 HIGHWAY 81",
"address_2": "STE 100",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300529112",
"telephone_number": "706-549-1663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3440 HIGHWAY 81",
"address_2": "STE 100",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300529112",
"telephone_number": "706-549-1663"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER-LOGANVILLE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-02-03",
"last_updated": "2025-06-10",
"certification_date": "2025-06-10",
"status": "A",
"authorized_official_last_name": "BOBLITZ",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "706-433-3120"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.