Organization Active NPI

Georgia Spine and Orthopaedics ASC, LLC

  • Ambulatory Surgical Clinic/Center
  • Roswell, GA
National Provider Identifier
1679098693
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GEORGIA SPINE AND ORTHOPAEDICS ASC, LLC
Practice address
11650 Alpharetta Hwy
Roswell, GA 30076-3805
Phone
(404) 596-5670
NPI assigned
Aug 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Erik Thor Bendiks, MDNPI 1518959006
Title
President
Phone
(404) 596-5670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

11650 Alpharetta Hwy
Roswell, GA 30076-3805

Mailing address

11650 Alpharetta Hwy
Roswell, GA 30076-3805
Phone (404) 596-5670

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2141591Georgia Spine and Orthopaedics ASC, LLC11650 Alpharetta Highway, Suite 200, Roswell, GA 30076Certificate of waiverDec 17, 2027
11D2295869Georgia Spine & Orthopaedics11650 Alpharetta Highway, Suite 100, Roswell, GA 30076Certificate of waiverDec 18, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679098693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 ALPHARETTA HWY",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763805",
            "telephone_number": "404-596-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 ALPHARETTA HWY",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763805",
            "telephone_number": "404-596-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA SPINE AND ORTHOPAEDICS ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-10",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BENDIKS",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "THOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-596-5670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.