Individual provider Active NPI

Keith D. Osborn, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Cumming, GA
National Provider Identifier
1407843568
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
029225 Issued in GA
Practice address
2000 Howard Farm Dr
Cumming, GA 30041-6075
Phone
(404) 234-1234
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 029225 GA Primary
Orthopaedic Surgery Physician 207X00000X 029225 GA

Addresses

Primary practice location

2000 Howard Farm Dr
Cumming, GA 30041-6075

Mailing address

2000 Howard Farm Dr
Cumming, GA 30041-6075

Other identifiers 1

IdentifierTypeStateIssuer
000339061AMedicaidGA

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
I20081105000063 GA Practitioner - Orthopedic Surgery 6608935747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Maryland School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

100 Mountain View Dr
Suite 100
Cumming, GA 30040-2434
Phone (770) 889-2163

4700 Nelson Brogdon Blvd
Suite 240
Buford, GA 30518-5401
Phone (770) 271-3188

4800 Olde Towne Pkwy
Suite 430
Marietta, GA 30068-4424
Phone (770) 517-6636

5513 Chamblee Dunwoody Rd
Suite 430
Dunwoody, GA 30338-4106
Phone (770) 551-9633

655 Molly LN
Suite 100
Woodstock, GA 30189-6519
Phone (770) 517-1080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as individual
Quality
75.02
Promoting interoperability
77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion172
Laminectomy or laminotomy (partial removal of spine bones)117
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029225GAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC CurrentSince Jan 19, 2019 Accepting new patients

Locations

2000 Howard Farm Dr
Ste 305
Cumming, GA 30041
Phone (404) 847-4180

4800 Olde Towne Pkwy
Ste 430
Marietta, GA 30068
Phone (770) 321-1001

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1407843568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HOWARD FARM DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HOWARD FARM DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416075",
            "telephone_number": "404-234-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORN",
        "first_name": "KEITH",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "GA",
            "license": "029225",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "029225",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000339061A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.