Athens Orthopedic Clinic Ambulatory Surgery Center, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Athens, GA
NPI 1477586063 · NPPES record last updated Jun 6, 2025
Key facts
- NPI
- 1477586063
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER, LLC
- Practice address
- 1765 Old West Broad St BLDG 1-300
Athens, GA 30606-2887 - Phone
- (706) 549-1663
- Fax
- (706) 546-8792
- NPI assigned
- Jul 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Michael Boblitz
- Title
- Ceo
- Phone
- (706) 433-3120
Practitioners 1
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Athens Orthopedic Clinic Ambulatory Surgery Center
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061129000314 | GA | Part B Supplier - Ambulatory Surgical Center | 0143228189 | Practice locations: Athens, GA |
National Provider Directory
Locations
1765 Old West Broad St
Bldg 1300
Athens, GA 30606
1765 Old West Broad St
Bldg 1
Athens, GA 30606
Phone (706) 208-0451
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
1765 Old West Broad St BLDG 1-300
Athens, GA 30606-2887
Mailing address
1765 Old West Broad St BLDG 1-300
Athens, GA 30606-2887
Phone (706) 549-1663
Other providers in Athens, GA
- Athens OBGYN II LLC
- Athens Obstetrics and Gynecology, LLC
- Athens Optical Inc
- Athens Oral & Maxillo Facial Surgery, PC
- Athens Orthopedic Associates, PC
- Athens Orthopedic Clinic, PA
- Athens Orthopedic Clinic, PA
- Athens Orthopedic Clinic, PA
- Athens Orthopedic Clinic, PA
- Athens Orthopedic Clinic, PA
All providers in Athens, GA · Ambulatory Surgical Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.