NPIMap

Organization Active NPI

Gwinnett Orthopaedic & Sports Medicine

  • Orthopaedic Surgery Physician
  • Duluth, GA
National Provider Identifier
1881791200
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
GWINNETT ORTHOPAEDIC & SPORTS MEDICINE
Practice address
1455 Pleasant Hill Road
Suite 501
Duluth, GA 30096
Phone
(404) 296-5005
Fax
(404) 296-5058
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Chera L Hudson
Title
Billing Manager
Phone
(404) 296-5005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X GA Primary

Addresses

Primary practice location

1455 Pleasant Hill Road
Suite 501
Duluth, GA 30096

Mailing address

1455 Pleasant Hill Road
Suite 501
Duluth, GA 30096
Phone (404) 296-5005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040220000076 GA Part B Supplier - Clinic/Group Practice 0648165373 Receives reassigned benefits from 2 practitioners
Practice locations: Decatur, GA; Loganville, GA; Snellville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881791200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 PLEASANT HILL ROAD",
            "address_2": "SUITE 501",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "404-296-5005",
            "fax_number": "404-296-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 PLEASANT HILL ROAD",
            "address_2": "SUITE 501",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "404-296-5005",
            "fax_number": "404-296-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT ORTHOPAEDIC & SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "CHERA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "404-296-5005"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.