Providence Orthopedics & Sports Medicine, PC

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

055950 Issued in GA

Legal business name

PROVIDENCE ORTHOPEDICS & SPORTS MEDICINE, PC

Practice address

1401 W Spring St
Suite 200
Monroe, GA 30655-1760

Phone

(770) 267-0978

Fax

(770) 207-7842

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David C Harkins I, D.O.NPI 1376592261

Title

President

Phone

(770) 267-0978

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• David Christopher Harkins, DO

  • Orthopaedic Surgery Physician
  • Monroe, GA
  • NPI 1376592261
  NPD Authorized official
• Douglas Brian Kasow, D.O.

  • Orthopaedic Surgery Physician
  • Lawrenceville, GA
  • NPI 1972552842
  NPD (past)
• Michael Shane Smith, MD

  • Orthopaedic Surgery Physician
  • Loganville, GA
  • NPI 1437199312
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262131200000",
    "number": "1881895035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W SPRING ST",
            "address_2": "SUITE 200",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306551760",
            "telephone_number": "770-267-0978",
            "fax_number": "770-207-7842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W SPRING ST",
            "address_2": "SUITE 200",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306551760",
            "telephone_number": "770-267-0978",
            "fax_number": "770-207-7842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE ORTHOPEDICS & SPORTS MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2009-12-30",
        "status": "A",
        "authorized_official_last_name": "HARKINS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-267-0978",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "GA",
            "license": "055950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Anesthesia Associates
• Premier Kids Care, Inc.
• Premier Kids Care, Inc.
• Premise Health of Georgia Medical PC
• Progressive Counseling Solutions LLC
• Pruitthealth Home Health, Inc.
• Publix Super Markets, Inc
• Pure-Hearted Medical Trans. LLC
• Tyler Pyles, D.P.T.
• Adeel Rahman, M.D.

• Adult Reconstructive Orthopaedic Surgery Physician in Monroe, GA
• Providers in Monroe, GA by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.