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EDG SPORTS MEDICINE,INC
NPI 1114169703
Physician Assistant - Surgical in Decatur, GA

Active since March 30, 2009
2801 N DECATUR RD, SUITE 200, DECATUR, GA 30033(404) 296-5005(404) 296-5058 Get Directions Write a Review

NPPES record last updated: March 30, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Edg Sports Medicine,inc NPPES

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

EDG SPORTS MEDICINE,INC (NPI 1114169703) is a healthcare organization registered as a surgical in Decatur, Georgia and active in the NPI registry since March 2009. The organization lists Eric Gaines, Owner, as its authorized official.

NPPES Registry Identity

NPI1114169703
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NameEDG SPORTS MEDICINE,INC
Location Address2801 N DECATUR RD, SUITE 200Decatur, GA 30033-5949
Mailing Address1230 Briarvista WayAtlanta, GA 30329 · (404) 296-5005 · Fax (404) 296-5058
Phone(404) 296-5005
Fax(404) 296-5058
Organization SubpartNo
Authorized OfficialEric GainesOwner · (404) 296-5005
Enumeration DateMarch 30, 2009
✔ NPI 1114169703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in GA · 1857
2801 N DECATUR RD, Decatur, GA 30033
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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 SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

TIFFANY A CLERK DPT
Physical Therapist
2801 N DECATUR RD, SUITE 230
DECATUR, GA 30033
Dekalb County (404) 294-7211
DR. NICHOLAS CHURCH MD
Family Medicine
2801 N DECATUR RD, SUITE 295
DECATUR, GA 30033
Dekalb County (404) 778-6400
DONALD C SIEGEL MD PC
Surgery
2801 N DECATUR RD, SUITE 180
DECATUR, GA 30033
Dekalb County (404) 297-0098
ATLANTA SPINE SPECIALISTS, LLC
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
2801 N DECATUR RD, STE 200
DECATUR, GA 30033
Dekalb County (404) 296-5005
DONALD C, SIEGEL, M.D., F.A.C.S.
Emergency Medical Technician, Intermediate
2801 N DECATUR RD
DECATUR, GA 30033
Dekalb County (404) 297-0098
TARA GAMBILL DPT
Physical Therapist
2801 N DECATUR RD, SUITE 230
DECATUR, GA 30033
Dekalb County (404) 294-7211
JEAN H. FIEDLER MD
Internal Medicine
2801 N DECATUR RD, SUITE 295
DECATUR, GA 30033
Dekalb County (404) 778-6400
OMS, LLC
Physician Assistant
2801 N DECATUR RD
DECATUR, GA 30033
Dekalb County (404) 296-5005

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 Edg Sports Medicine,inc's NPI number?

The NPI number for Edg Sports Medicine,inc is 1114169703. It was assigned to this organization in the NPPES registry on March 30, 2009.

Where is Edg Sports Medicine,inc located?

Edg Sports Medicine,inc is located at 2801 N Decatur Rd Suite 200, Decatur, GA 30033. The listed phone number is (404) 296-5005.

What is Edg Sports Medicine,inc's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Edg Sports Medicine,inc was last updated on March 30, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.