South Atl Ortho & SPTS

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

033313 Issued in GA

Legal business name

SOUTH ATL ORTHO & SPTS

Practice address

425 Forest Parkway
Suite 111
Forest Park, GA 30297-2342

Phone

(404) 362-9935

Fax

(404) 362-9938

NPI assigned

Oct 17, 2007

Organization subpart

Yes

Parent organization

SOUTH ATLANTA ORTHOPEDICS & SPORTS MEDICINEAs reported in NPPES

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

Authorized official

Name

Dr. Alexander Nicholas Doman, M.D.

Title

Owner/President

Phone

(404) 362-9935

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alexander N. Doman, MD Other name

Part of

South Atlanta Ortho Sports

Locations

Practitioners 1

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

• Kelly Christine Stubblefield, FNP-C

  • Family Nurse Practitioner
  • Pensacola, FL
  • NPI 1598877953
  NPD (past)

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254441600000",
    "number": "1639368459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 FOREST PKWY",
            "address_2": "SUITE111",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302972185",
            "telephone_number": "404-362-9935",
            "fax_number": "404-362-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 FOREST PARKWAY",
            "address_2": "SUITE 111",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302972342",
            "telephone_number": "404-362-9935",
            "fax_number": "404-362-9938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ATL ORTHO & SPTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH ATLANTA ORTHOPEDICS & SPORTS MEDICINE",
        "enumeration_date": "2007-10-17",
        "last_updated": "2009-10-02",
        "status": "A",
        "authorized_official_last_name": "DOMAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "404-362-9935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "033313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000444881A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alexander N. Doman, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• David James Shaver
• Dewayne S Shaw, DDS
• Katrice Simmons, SPECIMEN COLLECTOR
• Thomas Wortham Simmons Jr., R.PH.
• Ali Malik Smith, PHARM D
• South Atlanta Joint & Rehab
• South Atlanta Mua Center, LLC
• South Atlanta Spine and Joint Center LLC
• Southern Care Medical Transport LLC
• Southern Crescent Family Practice, LLC

• Medical Specialty Clinic/Center in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Medical Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.