Organization Active NPI

Dominion Orthopaedic Clinic, LLC

  • Durable Medical Equipment & Medical Supplies
  • Cumming, GA
National Provider Identifier
1679806889
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DOMINION ORTHOPAEDIC CLINIC, LLC
Practice address
5830 Bond St
Suite 200
Cumming, GA 30040-0307
Phone
(770) 455-4009
Fax
(770) 455-4065
NPI assigned
Sep 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Authorized official

Name
John I Foster III, MD
Title
President
Phone
(770) 455-4009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

5830 Bond St
Suite 200
Cumming, GA 30040-0307

Mailing address

5555 Peachtree Dunwoody Rd NE
Suite 215
Atlanta, GA 30342-1703
Phone (770) 455-4009

Other identifiers 1

IdentifierTypeStateIssuer
GRP7986OtherGAMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

5555 Peachtree Dunwoody Rd
Ste 215
Sandy Springs, GA 30342
Phone (404) 574-6863

NPI Registry JSON

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252368000000",
    "number": "1679806889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 215",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "770-455-4009",
            "fax_number": "770-455-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 BOND ST",
            "address_2": "SUITE 200",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300400307",
            "telephone_number": "770-455-4009",
            "fax_number": "770-455-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION ORTHOPAEDIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-08",
        "last_updated": "2009-09-08",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-455-4009",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GRP7986",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.