NPIMap

Organization Active NPI

Optim Orthopedics, LLC

Doing business as Optim Orthopedics

  • Orthopaedic Surgery Physician
  • Blackshear, GA
National Provider Identifier
1447627641
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
OPTIM ORTHOPEDICS, LLC
Doing business as
Optim Orthopedics
Practice address
3345 US Highway 84
Suite 100
Blackshear, GA 31516-2159
Phone
(912) 629-6942
Fax
(912) 644-5280
NPI assigned
Aug 24, 2015
Last updated
Aug 24, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
OPTIM ORTHOPEDICS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Authorized official

Name
Mr. Mark W Miller
Title
Practice Administrator
Phone
(912) 644-1626

Specialties & licenses 1

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

Addresses

Primary practice location

3345 US Highway 84
Suite 100
Blackshear, GA 31516-2159

Mailing address

210 E Derenne Ave
Attn.: Provider Enrollment
Savannah, GA 31405-6736
Phone (912) 644-1626

Other names 1

  • Optim Orthopedics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Optim Orthopedics LLC13 organizations share this tax ID, including this one
Part of
Optim Orthopedics LLC

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1447627641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "address_2": "ATTN.: PROVIDER ENROLLMENT",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-1626",
            "fax_number": "912-644-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 US HIGHWAY 84",
            "address_2": "SUITE 100",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315162159",
            "telephone_number": "912-629-6942",
            "fax_number": "912-644-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIM ORTHOPEDICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPTIM ORTHOPEDICS, LLC",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "912-644-1626",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optim Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blackshear, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.