NPIMap

Organization Active NPI

Carrollton Orthopaedic Clinic PC

Doing business as Orthowest

  • Rheumatology Physician
  • Carrollton, GA
National Provider Identifier
1356483747
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
048440 Issued in GA
Legal business name
CARROLLTON ORTHOPAEDIC CLINIC PC
Doing business as
Orthowest
Practice address
150 Clinic Ave
Suite 101
Carrollton, GA 30117-4401
Phone
(770) 834-0873
NPI assigned
Feb 13, 2007
Last updated
Nov 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Authorized official

Name
Melanie JordanNPI 1083011704
Title
Business Office Manager
Phone
(770) 834-0873

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 048440 GA Primary
Orthopaedic Surgery Physician 207X00000X 16340 GA
Physical Medicine & Rehabilitation Physician 208100000X 055277 GA
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

150 Clinic Ave
Suite 101
Carrollton, GA 30117-4401

Mailing address

150 Clinic Ave
Suite 101
Carrollton, GA 30117-4401
Phone (770) 834-0873

Other practice location 1

1124 N Park St Ste M
Carrollton, GA 30117-2282
Phone (770) 834-0873

Other names 1

  • Orthowest Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040330001027 GA Part B Supplier - Clinic/Group Practice 7810989183 Receives reassigned benefits from 34 practitioners
Practice locations: Carrollton, GA
O20100930001026 GA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 7810989183 Practice locations: Carrollton, GA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

204 Allen Memorial Dr
Ste 102
Bremen, GA 30110
Phone (727) 755-0679

1124 N Park St
Ste L
Carrollton, GA 30117

1124 N Park St
Ste M
Carrollton, GA 30117
Phone (770) 834-0873

150 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-0873

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1356483747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CLINIC AVE",
            "address_2": "SUITE 101",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174401",
            "telephone_number": "770-834-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CLINIC AVE",
            "address_2": "SUITE 101",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174401",
            "telephone_number": "770-834-0873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1124 N Park St Ste M",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301172282",
            "country_code": "US",
            "telephone_number": "770-834-0873",
            "fax_number": "770-834-6118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARROLLTON ORTHOPAEDIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "770-834-0873"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "GA",
            "license": "048440",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "16340",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "055277",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthowest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.