Individual provider Active NPI

William a J Alexander Jackson Ross Jr Jr., M.D.

  • Orthopaedic Surgery Physician
  • Riverdale, GA
National Provider Identifier
1245282037
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
52433 Issued in KY
Practice address
33 Upper Riverdale Rd SW Ste 112
Riverdale, GA 30274-2642
Phone
(770) 897-7874
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 52433 KY Primary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 047650 GA

Addresses

Primary practice location

33 Upper Riverdale Rd SW Ste 112
Riverdale, GA 30274-2642

Mailing address

1920 Niskey Lake TRL SW
Atlanta, GA 30331-6326
Phone (404) 344-9755

Other identifiers 2

IdentifierTypeStateIssuer
00839462EMedicaidGA
52433OtherKYKY MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131017001197 GA Practitioner - Orthopedic Surgery 9133298581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Meharry Medical College School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Regional Physicians Management Group, LLCGroup PAC ID 9032491956, 27 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

11 Upper Riverdale Rd SW
Women's Center
Riverdale, GA 30274-2615
Phone (770) 991-8000

335 Upper Riverdale Rd
Jonesboro, GA 30236-1071
Phone (770) 907-5743

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
047650GAMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Regional Physicians Management Group, LLC CurrentSince Jun 13, 2024 Accepting new patients
Ascension Sacred Heart Gulf Past Accepting new patients
The Ross Orthopaedic Wellness Center Orthopaedic Surgery PastSince Oct 17, 2007 Accepting new patients

Locations

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

11 Upper Riverdale Rd SW
Ste 21
Riverdale, GA 30274

33 Upper Riverdale Rd SW
Ste 112
Riverdale, GA 30274
Phone (770) 996-3190

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1245282037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 NISKEY LAKE TRL SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303316326",
            "telephone_number": "404-344-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 UPPER RIVERDALE RD SW STE 112",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742642",
            "telephone_number": "770-897-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS JR",
        "first_name": "WILLIAM A J",
        "middle_name": "ALEXANDER JACKSON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "52433",
            "primary": true
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "GA",
            "license": "047650",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00839462E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAL LICENSE",
            "identifier": "52433",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.