Orthoxpress of Georgia

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

ORTHOXPRESS OF GEORGIA

Practice address

104 N Park Dr Ste 104
Fayetteville, GA 30214-1645

Phone

(470) 944-5290

NPI assigned

Oct 15, 2025

Organization subpart

Yes

Parent organization

ORTHOXPRESS OF GEORGIAAs reported in NPPES

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

Authorized official

Name

Jennifer C Bullock

Title

President

Phone

(662) 534-2298

Specialties & licenses 3

Addresses

Other names 1

• OrthoXpress of Fayetteville Doing business as

Tax ID family

Orthoxpress of Georgia3 organizations share this tax ID, including this one

Part of

Orthoxpress of Georgia

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Orthoxpress of Georgia

  • Physician Assistant
  • Roswell, GA
  • NPI 1124994264
  NPD tax ID
• Orthoxpress of Georgia

  • Physician Assistant
  • Marietta, GA
  • NPI 1144107038
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Orthoxpress of Georgia

  • Physician Assistant
  • Acworth, GA
  • NPI 1093481251
  NPPES parent name

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1427924554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 OXFORD RD",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523115",
            "telephone_number": "662-534-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N PARK DR STE 104",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141645",
            "telephone_number": "470-944-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOXPRESS OF GEORGIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHOXPRESS OF GEORGIA",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-534-2298"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OrthoXpress of Fayetteville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Optimistic Steps Behavioral Services, LLC
• Oral an Implant Surgery Specialists, PC
• Ortho Atlanta Surgery Center of Fayetteville
• Orthoatlanta Surgery Center of Fayetteville, LLC
• Orthoatlanta, LLC
• Esohe Osaghae, MSN, RN-BC, CCM
• Ajala Osagie, M.D.
• Sarah Grace Osborne, OT
• William Osborne, M.D.
• Mandy G Osburn, MPT

• All providers in Fayetteville, GA
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.