Active NPI
Brandon Dobo, M.S., A.T.C.
- Sports Medicine (Orthopaedic Surgery) Physician
- Atlanta, GA
National Provider Identifier
1578985180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- AT002179
- Practice address
- 410 Brookhaven Way NE
Atlanta, GA 30319-3177 - Phone
- (912) 674-6715
- NPI assigned
- Jan 16, 2014
- Last updated
- Mar 21, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | AT002179 | GA | Primary |
Addresses
Primary practice location
410 Brookhaven Way NE
Atlanta, GA 30319-3177
Mailing address
410 Brookhaven Way NE
Atlanta, GA 30319-3177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT002179 | GA | MD | Sports Medicine (Orthopaedic Surgery) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395360000000",
"number": "1578985180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 BROOKHAVEN WAY NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303193177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 BROOKHAVEN WAY NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303193177",
"telephone_number": "912-674-6715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOBO",
"first_name": "BRANDON",
"credential": "M.S., A.T.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-16",
"last_updated": "2014-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "GA",
"license": "AT002179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.