MEDICARE: DOMINION ORTHOPAEDIC CLINIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	174400000X	Specialist	037539	GA

General Provider Information

NPI Number	:	1518096122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOMINION ORTHOPAEDIC CLINIC, LLC

Provider Business Mailing Address
First Line	:	5555 PEACHTREE DUNWOODY RD NE
Second Line	:	SUITE 215
City	:	ATLANTA
State	:	GA
Zip	:	30342-1703
Country	:	US
Telephone Number	:	770-455-4009
Fax Number	:	770-455-4065

Provider Business Practice Location Address
First Line	:	6 CONCOURSE PKWY STE 260
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-6117
Country	:	US
Telephone Number	:	770-455-4009
Fax Number	:	770-455-4065

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	RUTH CLARK
Credential	:
Telephone Number	:	770-455-4009

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	01/04/2023

Similar Medicare Providers

1558741942 — CLERISSA COOPER LAPC
Practice Location Address:

6 CONCOURSE PKWY , SUITE 1650
ATLANTA, GA
30328-6117

Practice Phone: 404-408-2950
Practice Fax: 770-804-0018

1225566300 — ASPIRE FERTILITY GEORGIA, LLC
Practice Location Address:

6 CONCOURSE PKWY STE 250
ATLANTA, GA
30328-6117

Practice Phone: 678-274-6760
Practice Fax:

1568024693 — MS. LAUREN RAMOS APC
Practice Location Address:

6 CONCOURSE PKWY
ATLANTA, GA
30328-6117

Practice Phone: 904-404-2570
Practice Fax:

1841800901 — RELIANT HAVEN HEALTHCARE
Practice Location Address:

5721 SUFFEX GREEN LN
ATLANTA, GA
30339-6117

Practice Phone: 347-843-9927
Practice Fax:

1023971710 — NEXUS CARDIAC REHABILITATION
Practice Location Address:

1115 SPRINGWOOD CONNECTOR UNIT 302
ATLANTA, GA
30328-5883

Practice Phone: 470-306-8359
Practice Fax:

1831960103 — MEHAK SOHAIL MERCHANT MS, LPC, NCC
Practice Location Address:

50 GLENLAKE PKWY STE 120
ATLANTA, GA
30328-7270

Practice Phone: 800-736-3739
Practice Fax:

Directions to “DOMINION ORTHOPAEDIC CLINIC, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.