NPIMap

Organization Active NPI

Augusta Orthopedic & Sports Medicine Specialists PC

  • Orthopaedic Surgery Physician
  • Augusta, GA
National Provider Identifier
1457389504
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
AUGUSTA ORTHOPEDIC & SPORTS MEDICINE SPECIALISTS PC
Practice address
3650 J Dewey Gray Cir
Augusta, GA 30909-1867
Phone
(706) 863-9797
Fax
(706) 860-7686
NPI assigned
Jun 29, 2006
Last updated
Jan 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Ellen T College, RT
Title
Office Administrator
Phone
(706) 863-9797

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary
Orthopaedic Hand Surgery Physician 207XS0106X
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X
Orthopaedic Surgery of the Spine Physician 207XS0117X
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X
Orthopaedic Trauma Physician 207XX0801X

Addresses

Primary practice location

3650 J Dewey Gray Cir
Augusta, GA 30909-1867

Mailing address

3650 J Dewey Gray Cir
P O Box 14039
Augusta, GA 30909-1867
Phone (706) 863-9797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040413000795 GA Part B Supplier - Clinic/Group Practice 8527052463 Receives reassigned benefits from 58 practitioners
Practice locations: Evans, GA; Waynesboro, GA; Thomson, GA; Sandersville, GA; Louisville, GA; Augusta, GA
O20070328000000 SC Part B Supplier - Clinic/Group Practice 8527052463 Receives reassigned benefits from 29 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aiken, SC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

1298 Interstate Pkwy
Augusta, GA 30909
Phone (706) 229-6102

1298 Interstate Pkwy
#A
Augusta, GA 30909
Phone (706) 863-9797

1298 Interstate Pkwy
#B
Augusta, GA 30909

3736 Mike Padgett Hwy
Ste B
Augusta, GA 30906
Phone (706) 922-7680

811 13th St
Augusta, GA 30901
Phone 7067379250 ext. 109

2511 Associates Way
Evans, GA 30809
Phone (706) 722-3401

2511 Associates Way
Ste 1000
Evans, GA 30809

501 Sparta Rd
Sandersville, GA 31082
Phone (478) 552-3989

308 Mount Pleasant Rd
Thomson, GA 30824

399 Silver Bluff Rd
Aiken, SC 29803
Phone (803) 293-1540

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23890/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1457389504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 J DEWEY GRAY CIR",
            "address_2": "P O BOX 14039",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091867",
            "telephone_number": "706-863-9797",
            "fax_number": "706-860-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 J DEWEY GRAY CIR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091867",
            "telephone_number": "706-863-9797",
            "fax_number": "706-860-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTA ORTHOPEDIC & SPORTS MEDICINE SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "COLLEGE",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "706-863-9797",
        "authorized_official_credential": "RT"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.