NPIMap

Organization Active NPI

Athens Orthopedic Clinic, PA

  • Orthopaedic Surgery Physician
  • Loganville, GA
National Provider Identifier
1821481185
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ATHENS ORTHOPEDIC CLINIC, PA
Practice address
3440 Highway 81
Loganville, GA 30052-9112
Phone
(770) 554-5009
Fax
(706) 546-8792
NPI assigned
Mar 11, 2015
Organization subpart
Yes
Parent organization
ATHENS ORTHOPEDIC CLINIC, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Michael Boblitz
Title
Ceo
Phone
(706) 549-1663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

3440 Highway 81
Loganville, GA 30052-9112

Mailing address

1765 Old West Broad St BLDG 2-200
Athens, GA 30606-2887
Phone (706) 549-1663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150825006042 GA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 5991600181 Practice locations: Loganville, GA

Other NPIs with the same Medicare PAC ID 6

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2164240Athens Orthopedic Clinic - Loganville MRI3440 Highway 81 South, Loganville, GA 30052Certificate of waiverMar 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Athens Orthopedic Clinic PA12 organizations share this tax ID, including this one
Part of
Athens Orthopedic Clinic PA

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1821481185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST BLDG 2-200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062887",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 HIGHWAY 81",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300529112",
            "telephone_number": "770-554-5009",
            "fax_number": "706-546-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS ORTHOPEDIC CLINIC, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATHENS ORTHOPEDIC CLINIC, PA",
        "enumeration_date": "2015-03-11",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "BOBLITZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-549-1663"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.