Atlanta Knee and Sports Medicine Institute Inc.
Organization Active NPI Orthopaedic Surgery Physician · Decatur, GA
NPI 1780779462 · NPPES record last updated Jun 12, 2024
Key facts
- NPI
- 1780779462
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- ATLANTA KNEE AND SPORTS MEDICINE INSTITUTE INC.
- Practice address
- 2801 N Decatur Rd
Suite 200
Decatur, GA 30033-5949 - Phone
- (404) 296-5005
- Fax
- (404) 296-5058
- NPI assigned
- Oct 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Brian Pallone
- Title
- Practice Administrator
- Phone
- (404) 296-5005
Practitioners 3
-
Maurice Jove, MD
-
Brian Pallone, AT., C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040526000531 | GA | Part B Supplier - Clinic/Group Practice | 3870574866 |
Receives reassigned benefits from 2 practitioners Practice locations: Decatur, GA; Loganville, GA |
National Provider Directory
Locations
2400 Wisteria Dr
Ste A
Snellville, GA 30078
Phone (770) 982-0102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | GA | Yes |
Addresses
Primary practice location
2801 N Decatur Rd
Suite 200
Decatur, GA 30033-5949
Mailing address
2801 N Decatur Rd
Suite 200
Decatur, GA 30033-5949
Phone (404) 296-5005
Other providers in Decatur, GA
- Atlanta Hearing Associates of Toco Hills, LLC
- Atlanta Heart Group PC
- Atlanta Holistic Health Center
- Atlanta Hyperbaric & Wound Care Clinic, L.L.C.
- Atlanta Insomnia and Behavioral Health Services, P.C.
- Atlanta Medical Equipment LLC
- Atlanta Metro Cardiology
- Atlanta Midtown VA Clinic
- Atlanta Neurosurgical Associates, P.a.
- Atlanta Orthopaedic and Spine LLC
All providers in Decatur, GA · Orthopaedic Surgery Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.