Organization Active NPI

Premier Orthopaedic Surgery, LLC

  • Orthopaedic Surgery Physician
  • Suwanee, GA
National Provider Identifier
1376602565
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PREMIER ORTHOPAEDIC SURGERY, LLC
Practice address
7360 McGinnis Ferry Rd
Suite E
Suwanee, GA 30024-6603
Phone
(678) 513-8111
Fax
(678) 990-1956
NPI assigned
Dec 6, 2006
Last updated
Aug 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Authorized official

Name
Wanda Hayes
Title
Office Manager
Phone
(678) 513-8111

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary
Orthopaedic Surgery of the Spine Physician 207XS0117X NU
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU

Addresses

Primary practice location

7360 McGinnis Ferry Rd
Suite E
Suwanee, GA 30024-6603

Mailing address

7360 McGinnis Ferry Rd
Suite E
Suwanee, GA 30024-6603
Phone (678) 513-8111

Other identifiers 1

IdentifierTypeStateIssuer
300044591AMedicaidGA

National Provider Directory

National Provider Directory

Locations

7360 McGinnis Ferry Rd
Ste E
Suwanee, GA 30024
Phone (678) 513-8111

Practitioners & affiliated clinicians

Practitioners 2

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": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1376602565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7360 MCGINNIS FERRY RD",
            "address_2": "SUITE E",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246603",
            "telephone_number": "678-513-8111",
            "fax_number": "678-990-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7360 MCGINNIS FERRY RD",
            "address_2": "SUITE E",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246603",
            "telephone_number": "678-513-8111",
            "fax_number": "678-990-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ORTHOPAEDIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "678-513-8111"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300044591A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.