Individual provider Active NPI

Edward Scott Middlebrooks, MD

  • Orthopaedic Surgery of the Spine Physician
  • Lawrenceville, GA
National Provider Identifier
1801810932
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
47624 Issued in GA
Practice address
758 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3385
Phone
(770) 962-4300
Fax
(770) 339-7544
NPI assigned
Jul 26, 2006
Last updated
Apr 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 47624 GA Primary

Addresses

Primary practice location

758 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3385

Mailing address

758 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3385
Phone (770) 962-4300

Other identifiers 2

IdentifierTypeStateIssuer
000842278GMedicaidGA
000842278FMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616000302 GA Practitioner - Orthopedic Surgery 5991790669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Alabama School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

3680 Pleasant Hill Rd
Suite 101
Duluth, GA 30096-3268
Phone (770) 813-5575

758 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3385
Phone (770) 962-4300

966 A Killian Hill Rd SW
Lilburn, GA 30047-3102
Phone (770) 923-4815

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47624GAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC Orthopaedic Surgery of the Spine CurrentSince Apr 1, 2010 Accepting new patients
Resurgens, LLC Orthopaedic Surgery of the Spine CurrentSince Mar 1, 2022 Accepting new patients
Resurgens, LLC CurrentSince Apr 1, 2010 Accepting new patients
Premier Orthopaedic Surgery, LLC Orthopaedic Surgery of the Spine Past Accepting new patients
Gwinnett Sports Medicine & Orthopaedic Surgery PC PastSince Aug 1, 2005 Accepting new patients

Locations

1223 Friendship Rd
Ste 220
Braselton, GA 30517
Phone (470) 762-3641

758 Old Norcross Rd
Ste 100
Lawrenceville, GA 30046
Phone (770) 962-4300

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

4025 Johns Creek Pkwy
Ste 100
Suwanee, GA 30024
Phone (404) 575-4500

Interoperability endpoints

  • Direct secure messaging: edward.middlebrooks.1@15749.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1801810932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 OLD NORCROSS RD",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463385",
            "telephone_number": "770-962-4300",
            "fax_number": "770-339-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 OLD NORCROSS RD",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463385",
            "telephone_number": "770-962-4300",
            "fax_number": "770-339-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLEBROOKS",
        "first_name": "EDWARD",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "GA",
            "license": "47624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000842278G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000842278F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.