Mark Spivey Orthopedic Clinic, LLC
NPI 1104017821 · Orthopaedic Surgery Physician · Vidalia, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mark Spivey Orthopedic Clinic, LLC is a Orthopaedic Surgery Physician organization in Vidalia, GA (NPI 1104017821).
Provider details
- NPI number
- 1104017821
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Charles Spivey, Owner(912) 537-4411
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Orthopaedic Surgery Physician207X00000X
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
5 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Mark Spivey Orthopedic Clinic, LLC
Additional practice locations (4)
- 242 Industrial BlvdDublin, GA 31021-2904Phone: (478) 272-3140Fax: (912) 538-8485
- 15 Yarbrough StHazlehurst, GA 31539-6341Phone: (912) 537-4411Fax: (912) 538-8485
- 601 Ferncrest DrSandersville, GA 31082-1800Phone: (912) 537-4411Fax: (912) 538-8485
- 305 Kite RdSwainsboro, GA 30401-5771Phone: (912) 537-4411Fax: (912) 538-8485
Registry dates
- Enumerated
- 2007-08-07
- Last updated
- 2026-06-04
- Certified
- 2026-06-04
Frequently asked questions
- What is Mark Spivey Orthopedic Clinic, LLC's NPI number?
- Mark Spivey Orthopedic Clinic, LLC's National Provider Identifier (NPI) is 1104017821, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mark Spivey Orthopedic Clinic, LLC?
- Mark Spivey Orthopedic Clinic, LLC is classified in the NPPES registry as Orthopaedic Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Mark Spivey Orthopedic Clinic, LLC located?
- Mark Spivey Orthopedic Clinic, LLC's practice location on file with NPPES is 3301 E 1st St, Vidalia, GA 30474-8674.
- What is Mark Spivey Orthopedic Clinic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Mark Spivey Orthopedic Clinic, LLC is (912) 537-4411.
- Does Mark Spivey Orthopedic Clinic, LLC accept Medicare?
- Mark Spivey Orthopedic Clinic, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Mark Spivey Orthopedic Clinic, LLC?
- The authorized official listed on Mark Spivey Orthopedic Clinic, LLC's NPPES record is Charles Spivey, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mark Spivey Orthopedic Clinic, LLC's NPI active?
- Yes — Mark Spivey Orthopedic Clinic, LLC's NPI (1104017821) is active in the NPPES registry as of the last update on 2026-06-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.