Sports Medicine of Gwinnett

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SPORTS MEDICINE OF GWINNETT

Practice address

3855 Pleasant Hill Rd
Suite 470
Duluth, GA 30096-1407

Phone

(770) 813-8888

Fax

(770) 813-0007

NPI assigned

Aug 11, 2009

Organization subpart

No

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

Authorized official

Name

Timothy Scott Maughon, M.D.

Title

Physician

Phone

(770) 813-8888

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Mathew William Pombo, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Duluth, GA
  • NPI 1346413648
  NPD

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249948800000",
    "number": "1982836862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 PLEASANT HILL RD",
            "address_2": "SUITE 470",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961407",
            "telephone_number": "770-813-8888",
            "fax_number": "770-813-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 PLEASANT HILL RD",
            "address_2": "SUITE 470",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961407",
            "telephone_number": "770-813-8888",
            "fax_number": "770-813-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE OF GWINNETT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-11",
        "last_updated": "2009-08-11",
        "status": "A",
        "authorized_official_last_name": "MAUGHON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-813-8888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kirthi Srinivasan, PT, DPT
• Cabrina St Louis
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• John Lee Stanton Jr., AGPCNP-BC, APRN
• Kelley Wages Starnes, CNM

• Specialist in Duluth, GA
• Providers in Duluth, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.