Phoenix Ortho Injury Spine and Extremity Medical Services LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PHOENIX ORTHO INJURY SPINE AND EXTREMITY MEDICAL SERVICES LLC

Practice address

1805 Parke Plaza Cir Ste 101
Stone Mountain, GA 30087-3646

Phone

(919) 451-2129

NPI assigned

Jan 12, 2024

Organization subpart

No

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

Authorized official

Name

Brian Adam

Title

Owner

Phone

(919) 451-2129

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1396516860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 PARKE PLAZA CIR STE 101",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 PARKE PLAZA CIR STE 101",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873646",
            "telephone_number": "919-451-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX ORTHO INJURY SPINE AND EXTREMITY MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "ADAM",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-451-2129"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Pham, DPT
• Mia Phan
• Philemon Healthcare Services LLC
• Philemon Surgical Associates Inc
• Adrian Philpot
• Phoenix Ortho Injury Spine and Extremity Surgery Center
• Melina Pierre Hayes
• Claudette Pile
• Andrea Pindling, NP
• Nena Watson Pinnix

• Orthopaedic Surgery Physician in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Orthopaedic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.