=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437004843
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORIGINS SPINE AND JOINT PHYSICIANS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2026
-----------------------------------------------------
Last Update Date | 03/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1485 JESSE JEWELL PKWY NE STE 180
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30501-3802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-521-8413
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1747 LANGFORD DR BLDG 400
-----------------------------------------------------
City | WATKINSVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30677-7310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-521-8413
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | STEVE RICHARD CRIDER JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 706-521-8413
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208VP0014X
-----------------------------------------------------
Taxonomy Name | Interventional Pain Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------