NPIMap

Organization Active NPI

Orthopedic Surgeons of Georgia LLC

  • Orthopaedic Surgery Physician
  • Douglas, GA
National Provider Identifier
1427337294
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPEDIC SURGEONS OF GEORGIA LLC
Practice address
100 Doctors Dr Ste I
Douglas, GA 31533-2211
Phone
(912) 383-6575
NPI assigned
Aug 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Mrs. Lavonda L. Cravey
Title
VP of Corporate Revenue Cycle
Phone
(912) 384-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X GA Primary

Addresses

Primary practice location

100 Doctors Dr Ste I
Douglas, GA 31533-2211

Mailing address

PO Box 1377
Douglas, GA 31534-1377

Other practice location 1

1508 Tebeau St
Waycross, GA 31501-5327
Phone (912) 383-6575

Other practice location 2

2804 N Oak St Ste C
Valdosta, GA 31602-5913
Phone (229) 387-8061

Other practice location 3

1622 Madison Ave
Tifton, GA 31794-3756
Phone (229) 387-8061

Other practice location 4

1050 Valdosta Hwy
Homerville, GA 31634-9701
Phone (912) 383-6575

Other practice location 5

11 Cross St
Hazlehurst, GA 31539-6427
Phone (912) 383-6575

Other names 1

  • Orthopedic Surgeons of Georgia Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111110000769 GA Part B Supplier - Clinic/Group Practice 5597939421 Receives reassigned benefits from 9 practitioners
4 other NPIs on this enrollment
Practice locations: Douglas, GA; Hazlehurst, GA; Homerville, GA; Tifton, GA; Valdosta, GA; Waycross, GA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

411 Lister St
Waycross, GA 31501
Phone (706) 206-9786

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1427337294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1377",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315341377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DOCTORS DR STE I",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332211",
            "telephone_number": "912-383-6575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1508 Tebeau St",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315015327",
            "country_code": "US",
            "telephone_number": "912-383-6575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2804 N Oak St Ste C",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316025913",
            "country_code": "US",
            "telephone_number": "229-387-8061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1622 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Tifton",
            "state": "GA",
            "postal_code": "317943756",
            "country_code": "US",
            "telephone_number": "229-387-8061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 Valdosta Hwy",
            "address_purpose": "LOCATION",
            "city": "Homerville",
            "state": "GA",
            "postal_code": "316349701",
            "country_code": "US",
            "telephone_number": "912-383-6575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 Cross St",
            "address_purpose": "LOCATION",
            "city": "Hazlehurst",
            "state": "GA",
            "postal_code": "315396427",
            "country_code": "US",
            "telephone_number": "912-383-6575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHOPEDIC SURGEONS OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-11",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "CRAVEY",
        "authorized_official_first_name": "LAVONDA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VP OF CORPORATE REVENUE CYCLE",
        "authorized_official_telephone_number": "912-384-1900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopedic Surgeons of Georgia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.