Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sports Medicine South of Gwinnett LLC

Organization Sports Medicine (Orthopaedic Surgery) Physician · NPI 1265053110

Sports Medicine South of Gwinnett LLC is a Sports Medicine (Orthopaedic Surgery) Physician in Lawrenceville, Georgia. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1900 Riverside Pkwy
Lawrenceville, GA 30043-5925
Phone: (770) 237-3475
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X

Record details

NPI number1265053110
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amy Fouts — Chief Compliance Officer · (404) 851-6968
NPI enumeratedMay 1, 2020
Last updated in NPPESMay 18, 2026
Certification dateMay 18, 2026
Mailing address1001 Summit Blvd Ste 1000, Brookhaven, GA 30319-6415

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