NPIMap

Individual provider Active NPI

Adam M Sunderland, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Villa Rica, GA
National Provider Identifier
1609196872
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
073845 Issued in GA
Practice address
705 Dallas Hwy Ste 301
Villa Rica, GA 30180
Phone
(770) 456-0211
NPI assigned
Jun 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 073845 GA
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 073845 GA Primary

Addresses

Primary practice location

705 Dallas Hwy Ste 301
Villa Rica, GA 30180

Mailing address

150 Clinic Ave Ste 101
Carrollton, GA 30117-4402
Phone (770) 834-0873

Other practice location 1

538 N Superior Ave
Decatur, GA 30033-5402
Phone (555) 555-5555

Other practice location 2

150 Clinic Ave Ste 101
Carrollton, GA 30117-4402
Phone (770) 834-0873

Other identifiers 3

IdentifierTypeStateIssuer
003166316JMedicaidGA
003166316KMedicaidGA
003166316IMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923001402 GA Practitioner - Orthopedic Surgery 6406089697 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carrollton Orthopaedic Clinic PCGroup PAC ID 7810989183, 31 clinicians

Practice addresses (Care Compare)

150 Clinic Ave
Carrollton, GA 30117-4498
Phone (770) 834-0873

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement47
Knee replacement18
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
073845GAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc Orthopaedic Surgery CurrentSince Aug 1, 2015 Accepting new patients
Carrollton Orthopaedic Clinic PC Orthopaedic Surgery CurrentSince Jun 1, 2019 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Aug 1, 2015 Accepting new patients
The Emory Clinic Inc CurrentSince Aug 1, 2015 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

204 Allen Memorial Dr
Ste 102
Bremen, GA 30110
Phone (727) 755-0679

150 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-0873

150 Clinic Ave
Ste 101
Carrollton, GA 30117
Phone (770) 834-0873

401 Permian Way
Ste D
Villa Rica, GA 30180

705 Dallas Hwy
Ste 301
Villa Rica, GA 30180
Phone (770) 456-0211

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1609196872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CLINIC AVE STE 101",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174402",
            "telephone_number": "770-834-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DALLAS HWY STE 301",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "30180",
            "telephone_number": "770-456-0211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "538 N Superior Ave",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300335402",
            "country_code": "US",
            "telephone_number": "555-555-5555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Clinic Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301174402",
            "country_code": "US",
            "telephone_number": "770-834-0873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUNDERLAND",
        "first_name": "ADAM",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-10",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "073845",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "GA",
            "license": "073845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003166316J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003166316K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003166316I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.