Mark Spivey Orthopedic Clinic, LLC
NPI 1104017821ActiveOrganization· Orthopaedic Surgery· Vidalia, GA
Orthopaedic Surgery in Vidalia, Georgia, registered in NPPES in August 2007. The authorized official on file is Charles M. Spivey, MD, Owner. Enrolled in Medicare as dme supplier - physician - orthopedic/orthopedic surgery and part b supplier - clinic/group practice.
Overview
| NPI | 1104017821 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 7, 2007 |
| Last updated in NPPES | Jun 4, 2026 |
| Certified by provider | Jun 4, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Orthopaedic Surgery Primary | 207X00000X | — | — |
| Orthopaedic Surgery | 207X00000X | 047846 | GA |
| Orthopaedic Surgery | 207X00000X | — | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Orthopedic/Orthopedic Surgery (GA); Part B Supplier - Clinic/Group Practice (GA) |
|---|
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