NPIMap

Organization Active NPI

Peachtree Orthopaedic Clinic, P.a.

  • Durable Medical Equipment & Medical Supplies
  • Braselton, GA
National Provider Identifier
1245085885
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PEACHTREE ORTHOPAEDIC CLINIC, P.A.
Practice address
1524 River PL Ste 200
Braselton, GA 30517-5614
Phone
(404) 355-0743
Fax
(833) 450-5581
NPI assigned
Apr 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Tolan Edward Mitchell, CFO
Title
Cfo
Phone
(404) 350-4703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1524 River PL Ste 200
Braselton, GA 30517-5614

Mailing address

2001 Peachtree Rd NE Ste 705
Atlanta, GA 30309-1476
Phone (404) 355-0743

Other names 1

  • Peachtree Orthopedics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peachtree Orthopaedic C17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Practitioners & affiliated clinicians

Practitioners 1

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": "1713398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1245085885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 PEACHTREE RD NE STE 705",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091476",
            "telephone_number": "404-355-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 RIVER PL STE 200",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305175614",
            "telephone_number": "404-355-0743",
            "fax_number": "833-450-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE ORTHOPAEDIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "TOLAN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "404-350-4703",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Braselton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.