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MARK SPIVEY ORTHOPEDIC CLINIC, LLC
NPI 1104017821
Orthopaedic Surgery in Vidalia, GA

Active since August 07, 2007CLIA 11D2057950 · Waiver
3301 E 1ST ST, STE A, VIDALIA, GA 30474(912) 537-4411(912) 538-8485 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 4, 2026, Mar 14, 2025, Feb 3, 2025 (3 updates tracked since 2025).

About Mark Spivey Orthopedic Clinic, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK SPIVEY ORTHOPEDIC CLINIC, LLC (NPI 1104017821) is a healthcare organization registered as an orthopaedic surgery in Vidalia, Georgia and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through December 19, 2026, maintains 4 additional practice locations, and lists Charles M Spivey, Owner, as its authorized official.

NPPES Registry Identity

NPI1104017821
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameMARK SPIVEY ORTHOPEDIC CLINIC, LLC
Location Address3301 E 1ST ST, STE AVidalia, GA 30474-8674
Mailing Address3301 E 1st St Ste AVidalia, GA 30474-8674 · (912) 537-4411 · Fax (912) 538-8485
Phone(912) 537-4411
Fax(912) 538-8485
Organization SubpartNo
Authorized OfficialCharles M SpiveyOwner · (912) 537-4411
Enumeration DateAugust 7, 2007
Last NPPES UpdateJune 4, 20263 updates tracked since enumeration
NPPES CertifiedJune 4, 2026
✔ NPI 1104017821 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in GA · 047846
Definition
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.
3301 E 1ST ST, Vidalia, GA 30474
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Other Names 1

Doing Business AsMark Spivey Orthopedic Clinic, Llc

Secondary Practice Locations 4

Location 1305 Kite RdSwainsboro, GA 30401-5771 · Phone (912) 537-4411 · Fax (912) 538-8485
Location 215 Yarbrough StHazlehurst, GA 31539-6341 · Phone (912) 537-4411 · Fax (912) 538-8485
Location 3242 Industrial BlvdDublin, GA 31021-2904 · Phone (478) 272-3140 · Fax (912) 538-8485
Location 4601 Ferncrest DrSandersville, GA 31082-1800 · Phone (912) 537-4411 · Fax (912) 538-8485

Other Identifiers 1

Medicaid501468518EGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2057950

Mark Spivey Orthopedic Clinic · Vidalia, GA
Active · expires Dec 19, 2026
CLIA Number11D2057950
Laboratory TypePhysician Office
Certificate Effective DateDecember 20, 2024
Certificate Expiration DateDecember 19, 2026
Laboratory DirectorDr. John C. Spivey
Laboratory Phone(912) 537-4411
Laboratory LocationMark Spivey Orthopedic Clinic3301 East First Street, Suite A, Vidalia, GA 30474
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTIAN ANDREW RAY PT, DPT, CSCS
Physical Therapist
3301 E 1ST ST
VIDALIA, GA 30474
Toombs County (912) 537-4411
RICHARD M PROENZA PA-C
Physician Assistant (Surgical)
3301 E 1ST ST, SUITE A
VIDALIA, GA 30474
Toombs County (912) 537-4411

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Spivey Orthopedic Clinic, LLC's NPI number?

The NPI number for Mark Spivey Orthopedic Clinic, LLC is 1104017821. It was assigned to this organization in the NPPES registry on August 7, 2007.

Where is Mark Spivey Orthopedic Clinic, LLC located?

Mark Spivey Orthopedic Clinic, LLC is located at 3301 E 1st St Ste A, Vidalia, GA 30474. The listed phone number is (912) 537-4411.

What is Mark Spivey Orthopedic Clinic, LLC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Does Mark Spivey Orthopedic Clinic, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2057950) is associated with this NPI, valid through December 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mark Spivey Orthopedic Clinic, LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Mark Spivey Orthopedic Clinic, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Spivey Orthopedic Clinic, LLC was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.