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ORTHOATLANTA LLC NPI 1043331978


NPI Information

NPI: 1043331978
Provider Name: ORTHOATLANTA, LLC
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization

CLIA Number: 11D0943171

Address:
771 OLD NORCROSS RD
SUITES 155 / 390
LAWRENCEVILLE, GA
ZIP 30046
Phone: (678) 205-4261
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ORTHOATLANTA, LLC is an orthopaedic surgery in Lawrenceville, GA. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. ORTHOATLANTA, LLC NPI is 1043331978. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

771 OLD NORCROSS RD
SUITES 155 / 390
LAWRENCEVILLE, GA
ZIP 30046-386
Phone: (678) 205-4261
Fax: (947) 417-7187

The provider's authorized official is Michael Ochal .
The authorized official title is Ceo and has the following contact phone number (770) 953-6929.

The CLIA number assigned to this NPI record is 11D0943171 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/2/2007 and was last updated on 9/13/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic SurgeryGEORGIAYes
2207XS0106XOrthopaedic SurgeryHand SurgeryNo
3207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryNo
4207XX0004XOrthopaedic SurgeryFoot and Ankle SurgeryNo
5207XX0005XOrthopaedic SurgerySports MedicineGEORGIANo
62081P2900XPhysical Medicine & RehabilitationPain MedicineGEORGIANo
72251X0800XPhysical TherapistOrthopedicGEORGIANo
8363A00000XPhysician AssistantGEORGIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1346603704OTHERGEORGIAUSDOL- GWINNETT
2=========004OTHERGEORGIATRICARE - GWINNETT
36285940012MEDICARE NSCGEORGIA
46285940012OTHERGEORGIANSC - DME (#155)
56285940003MEDICARE NSCGEORGIA
66285940003OTHERGEORGIADME (ALSO MEDICARE NSC)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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