Midwestern Advanced Orthopaedics and Sports Medicine Inc

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

6115 Issued in GA

Legal business name

MIDWESTERN ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE INC

Practice address

2801 N Decatur Rd
Suite 200
Decatur, GA 30033-5949

Phone

(404) 296-5005

Fax

(404) 296-2070

NPI assigned

Aug 19, 2011

Organization subpart

No

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

Authorized official

Name

Douglas Toussaint Johnson, PA-C

Title

Owner

Phone

(404) 296-5005

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1740560978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 HIGHLAND AVE NE",
            "address_2": "APT 1407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121391",
            "telephone_number": "404-296-5005",
            "fax_number": "404-296-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 N DECATUR RD",
            "address_2": "SUITE 200",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335949",
            "telephone_number": "404-296-5005",
            "fax_number": "404-296-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWESTERN ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "TOUSSAINT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-296-5005",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "6115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenda Doreen Middleton, LMSW
• Maurice Zivian Middleton, D.P.T.
• Tamer Yvette Middleton, MD
• Midtown Joint Care
• Sareena Lynn Miduski, LPC
• Angelique B Miles
• Jody Miles
• Milestone Family Medicine
• Milestone Pediatrics and Family Medicine
• Milestone Pediatrics LLC

• Surgical Physician Assistant in Decatur, GA
• Providers in Decatur, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.