Organization Active NPI

Athens Joint and Spine Center LLC

  • Ambulatory Surgical Clinic/Center
  • Athens, GA
National Provider Identifier
1942065552
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ATHENS JOINT AND SPINE CENTER LLC
Practice address
1765 Old West Broad St BLDG 3-400
Athens, GA 30606-2853
Phone
(706) 549-1663
NPI assigned
Feb 14, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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) 433-3120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1765 Old West Broad St BLDG 3-400
Athens, GA 30606-2853

Mailing address

1765 Old West Broad St BLDG 3-400
Athens, GA 30606-2853

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250710002085 GA Part B Supplier - Ambulatory Surgical Center 6608380605 Practice locations: Athens, GA

Ambulatory surgical center certification: CCN 11C0001589

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Athens Joint and Spine Center, LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jul 17, 2025
Last certification
Jul 21, 2025
Ownership / control type
Proprietary
Facility address
1765 Old West Broad St Bldg 3-400
Athens, GA 30606

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
11D2314369Athens Joint and Spine Center, LLC1765 Old West Broad Street, BLDG 3-300, Athens, GA 30606Certificate of waiverNov 18, 2026

National Provider Directory

National Provider Directory

Locations

1765 Old West Broad St
#3400
Athens, GA 30606

1765 Old West Broad St
Bldg 3
Athens, GA 30606

1765 Old West Broad St
Athens, GA 30606
Phone (706) 548-6881

1765 Old West Broad St
Bldg 3400
Athens, GA 30606
Phone (706) 286-7637

Practitioners & affiliated clinicians

Practitioners 1

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": "1707868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1942065552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST BLDG 3-400",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST BLDG 3-400",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062853",
            "telephone_number": "706-549-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS JOINT AND SPINE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-14",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "BOBLITZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-433-3120"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.