NPIMap

Organization Active NPI

Gwinnett Sports Medicine & Orthopaedic Surgery PC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Duluth, GA
National Provider Identifier
1710071931
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
GWINNETT SPORTS MEDICINE & ORTHOPAEDIC SURGERY PC
Practice address
10680 Medlock Bridge Road
Ste 102
Duluth, GA 30097
Phone
(770) 622-4499
Fax
(770) 622-0315
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Mr. Fred Woestmann
Title
Administrator
Phone
(770) 622-4499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

10680 Medlock Bridge Road
Ste 102
Duluth, GA 30097

Mailing address

10680 Medlock Bridge Road
Ste 102
Duluth, GA 30097
Phone (770) 622-4499

Other names 1

  • Atlanta Center for Athletes Doing business as

National Provider Directory

National Provider Directory

Locations

5805 State Bridge Rd
Ste G377
Johns Creek, GA 30097
Phone (770) 622-4499

10680 Medlock Bridge Rd
Ste 102
Johns Creek, GA 30097
Phone (404) 593-0090

Practitioners & affiliated clinicians

Practitioners 8

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1710071931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10680 MEDLOCK BRIDGE ROAD",
            "address_2": "STE 102",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-622-4499",
            "fax_number": "770-622-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10680 MEDLOCK BRIDGE ROAD",
            "address_2": "STE 102",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-622-4499",
            "fax_number": "770-622-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT SPORTS MEDICINE & ORTHOPAEDIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "WOESTMANN",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-622-4499",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlanta Center for Athletes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.