MOUNTAINSIDE ORTHOPEDICS NPI 1639293988

NPI Information

  • NPI: 1639293988
  • Provider Name: MOUNTAINSIDE ORTHOPEDICS
  • Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
  • Entity Type: Organization
  • Address: 620 J L WHITE DR
    SUITE 100
    JASPER, GA
    ZIP 30143
  • Phone: (706) 692-6980

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NPI Details

MOUNTAINSIDE ORTHOPEDICS is a durable medical equipment medical supplies in Jasper, GA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. MOUNTAINSIDE ORTHOPEDICS NPI is 1639293988. The provider is registered as an organization entity type.

The provider's business location address is:

620 J L WHITE DR
SUITE 100
JASPER, GA
ZIP 30143-896
Phone: (706) 692-6980

The provider's authorized official is Jennifer Tardif .
The authorized official title is Credentialing Manager and has the following contact phone number (770) 801-2526.

The enumeration date for this NPI number is 3/19/2007 and was last updated on 1/8/2009.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical Supplies035504GEORGIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15404790001MEDICARE NSCGEORGIA
220NCCJSMEDICARE ID-TYPE UNSPECIFIEDGEORGIA

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: 11/21/2025

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