South Ga Orthopedic Resources Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

L.O. 14 Issued in GA

Legal business name

SOUTH GA ORTHOPEDIC RESOURCES INC

Doing business as

Georgia Orthopedic Resources

Practice address

590 S Enota Dr NE Ste 1B
Gainesville, GA 30501-2433

Phone

(678) 960-4424

Fax

(678) 680-7903

NPI assigned

Apr 28, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Jake Eric Bentley, L.O.,C.O.

Title

Manager/Part Owner

Phone

(678) 960-4424

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Georgia Orthopedic Resources Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• South Ga Orthopedic Resources Inc

  • Prosthetic/Orthotic Supplier
  • Tifton, GA
  • NPI 1295918712

  3173725488

  Same PAC ID

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

Medicare medical equipment & supply locations

Tax ID family

South Gaorthopedic Resources2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• South Ga Orthopedic Resources Inc

  • Prosthetic/Orthotic Supplier
  • Tifton, GA
  • NPI 1295918712
  NPD tax ID

Locations

Practitioners 1

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

• Jacob Eric Bentley, CO, LO

  • Orthotist
  • Hiram, GA
  • NPI 1417127432
  NPD (past)

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1780094987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941617",
            "telephone_number": "229-386-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 S ENOTA DR NE STE 1B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012433",
            "telephone_number": "678-960-4424",
            "fax_number": "678-680-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GA ORTHOPEDIC RESOURCES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "JAKE",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "MANAGER/PART OWNER",
        "authorized_official_telephone_number": "678-960-4424",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.O.,C.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "GA",
            "license": "L.O. 14",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057062934C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Orthopedic Resources",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Georgia Orthopedic Resources",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.