Organization Active NPI

Thomasville Orthopedic Center, PC

  • Orthopaedic Surgery Physician
  • Thomasville, GA
National Provider Identifier
1902864754
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
THOMASVILLE ORTHOPEDIC CENTER, PC
Practice address
100 Mimosa Dr
Thomasville, GA 31792
Phone
(229) 226-9141
Fax
(229) 228-0637
NPI assigned
May 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Authorized official

Name
Frederick R Nusbickel, MD
Title
President
Phone
(229) 226-9144

Specialties & licenses 1

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

Addresses

Primary practice location

100 Mimosa Dr
Thomasville, GA 31792

Mailing address

PO Box 2968
Thomasville, GA 31799-2968
Phone (229) 226-9141

Other identifiers 2

IdentifierTypeStateIssuer
CB2303OtherGARAIL ROAD MEDICARE
0832790001OtherGADMERC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040507000644 GA Part B Supplier - Clinic/Group Practice 0143219949 Receives reassigned benefits from 3 practitioners
Practice locations: Cairo, GA; Thomasville, GA

National Provider Directory

National Provider Directory

Locations

100 Mimosa Dr
Ste 1R
Thomasville, GA 31792
Phone (229) 226-9141

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1902864754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2968",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317992968",
            "telephone_number": "229-226-9141",
            "fax_number": "229-228-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "31792",
            "telephone_number": "229-226-9141",
            "fax_number": "229-228-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMASVILLE ORTHOPEDIC CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "NUSBICKEL",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-226-9144",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CB2303",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0832790001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.