NPIMap

Organization Active NPI

Optim Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Swainsboro, GA
National Provider Identifier
1619360575
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
OPTIM ORTHOPEDICS, LLC
Practice address
119B Victory Dr
Swainsboro, GA 30401-3234
Phone
(478) 289-3198
Fax
(912) 644-5260
NPI assigned
Mar 16, 2015
Organization subpart
Yes
Parent organization
OPTIM ORTHOPEDICS, LLCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Michael W Kleinpeter
Title
Ceo
Phone
(912) 644-5300

Other NPIs on the same Medicare enrollment 30

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

View all 30

Practitioners 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20150429001342 GA Part B Supplier - Clinic/Group Practice 9931427002 Receives reassigned benefits from 144 practitioners
30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brunswick, GA; Vidalia, GA; Statesboro, GA; Savannah, GA; Rincon, GA; Richmond Hill, GA; Metter, GA; Jesup, GA…

National Provider Directory

National Provider Directory
Part of
Optim Orthopedics LLC

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

119B Victory Dr
Swainsboro, GA 30401-3234

Mailing address

210 E Derenne Ave
Attn.: Provider Enrollment
Savannah, GA 31405-6736
Phone (912) 644-5300

Other names 1

NPPES NPI Registry
  • Optim Orthopedics Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 16, 2015.

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1619360575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "address_2": "ATTN.: PROVIDER ENROLLMENT",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119B VICTORY DR",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013234",
            "telephone_number": "478-289-3198",
            "fax_number": "912-644-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIM ORTHOPEDICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPTIM ORTHOPEDICS, LLC",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "KLEINPETER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-644-5300"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optim Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Swainsboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.