NPIMap

Organization Active NPI

Peachtree Orthopaedic Clinic, PA

Doing business as Peachtree Orthopedics

  • Durable Medical Equipment & Medical Supplies
  • Dawsonville, GA
National Provider Identifier
1255107181
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PEACHTREE ORTHOPAEDIC CLINIC, PA
Doing business as
Peachtree Orthopedics
Practice address
142 Prestige LN Ste 400
Dawsonville, GA 30534-6253
Phone
(404) 355-0743
Fax
(404) 355-2136
NPI assigned
Dec 1, 2023
Last updated
Feb 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Authorized official

Name
Tolan Edward Mitchell
Title
Cfo
Phone
(404) 355-0743

Specialties & licenses 1

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

Addresses

Primary practice location

142 Prestige LN Ste 400
Dawsonville, GA 30534-6253

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

Locations

142 Prestige Ln
Ste 200
Dawsonville, GA 30534

142 Prestige Ln
Ste 400
Dawsonville, GA 30534

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1255107181",
    "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",
            "fax_number": "404-355-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 PRESTIGE LN STE 400",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346253",
            "telephone_number": "404-355-0743",
            "fax_number": "404-355-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE ORTHOPAEDIC CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-01",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "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": "404-355-0743"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peachtree Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 14, 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.