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SPORTS MEDICINE SOUTH OF GWINNETT LLC NPI 1265053110


NPI Information

NPI: 1265053110
Provider Name: SPORTS MEDICINE SOUTH OF GWINNETT LLC
Classification: Orthopaedic Surgery - 207XX0005X
Entity Type: Organization

Specialization: Sports Medicine

CLIA Number: 11D1085597

Address:
1900 RIVERSIDE PKWY
LAWRENCEVILLE, GA
ZIP 30043
Phone: (770) 237-3475
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SPORTS MEDICINE SOUTH OF GWINNETT LLC is a sports medicine orthopaedic surgery in Lawrenceville, GA. The provider is an orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. SPORTS MEDICINE SOUTH OF GWINNETT LLC NPI is 1265053110. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1900 RIVERSIDE PKWY
LAWRENCEVILLE, GA
ZIP 30043-925
Phone: (770) 237-3475

The provider's authorized official is Jorge Hernandez .
The authorized official title is Vp/cco and has the following contact phone number (404) 851-8000.

The CLIA number assigned to this NPI record is 11D1085597 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/1/2020 and was last updated on 8/12/2021.


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
1207XX0005XOrthopaedic SurgerySports MedicineYes

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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