Individual provider Active NPI

Neil Jay Negrin, MD

  • Orthopaedic Surgery Physician
  • Austell, GA
National Provider Identifier
1265435242
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
22610 Issued in GA
Practice address
3875 Austell Rd.
Ste 201
Austell, GA 30106-1153
Phone
(770) 819-1777
Fax
(770) 819-1730
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 22610 GA Primary

Addresses

Primary practice location

3875 Austell Rd.
Ste 201
Austell, GA 30106-1153

Mailing address

3875 Austell Rd
Ste 201
Austell, GA 30106-1103
Phone (770) 819-1777

Other identifiers 1

IdentifierTypeStateIssuer
00222659BMedicaidGA

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
I20050119000087 GA Practitioner - Orthopedic Surgery 1254380082 Practice locations: Atlanta, GA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22610GAMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1265435242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3875 AUSTELL RD",
            "address_2": "STE 201",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061103",
            "telephone_number": "770-819-1777",
            "fax_number": "770-819-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 AUSTELL RD.",
            "address_2": "STE 201",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061153",
            "telephone_number": "770-819-1777",
            "fax_number": "770-819-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRIN",
        "first_name": "NEIL",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "22610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00222659B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.