Southern Bone & Joint Ambulatory Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTHERN BONE & JOINT AMBULATORY SURGICAL CENTER, LLC

Doing business as

Georgia Bone and Joint Surgery Center
Southern Bone & Joint ASC, LLC
Southern Bone & Joint, LLC

Practice address

1755 Highway 34 E
Suite 1100
Newnan, GA 30265-5631

Phone

(770) 252-7510

Fax

(770) 252-7511

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5935

Specialties & licenses 1

Addresses

Other names 3

• Georgia Bone and Joint Surgery Center Doing business as
• Southern Bone & Joint ASC, LLC Doing business as
• Southern Bone & Joint, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Southern Bone and Joint ASC LLCCCN 11C0001187

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Georgia Bone and Joint Surgery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Southern Bone & Joint Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Atlanta, GA
  • NPI 1942370408
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Georgia Bone & Joint, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Covington, GA
  • NPI 1821855719

  Member Of

  NPD member

Locations

Practitioners 1

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

• Jayson Alan McMath, M.D.

  • Orthopaedic Surgery Physician
  • Newnan, GA
  • NPI 1083649073
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1528166113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 HIGHWAY 34 E",
            "address_2": "SUITE 1100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655631",
            "telephone_number": "770-252-7510",
            "fax_number": "770-252-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 HIGHWAY 34 E",
            "address_2": "SUITE 1100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655631",
            "telephone_number": "770-252-7510",
            "fax_number": "770-252-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BONE & JOINT AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5935"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Bone and Joint Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Bone & Joint ASC, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Bone & Joint, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Newnan, GA
• Providers in Newnan, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.