Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Edg Sports Medicine, Inc

Organization Surgical Physician Assistant · NPI 1114169703

Edg Sports Medicine, Inc provides Surgical Physician Assistant services in Decatur, Georgia. Licensed in Georgia. Registered with an NPI since 2009.

Licensed in
GA
In the registry since
2009
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2801 N Decatur Rd Ste 200
Decatur, GA 30033-5949 Not confirmed with CMS for 17 years — call before visiting
Phone: (404) 296-5005
Fax: (404) 296-5058
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 1857 (GA)

Record details

NPI number1114169703
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Eric Gaines — Owner · (404) 296-5005
NPI enumeratedMarch 30, 2009
Last updated in NPPESMarch 30, 2009
Mailing address1230 Briarvista Way, Atlanta, GA 30329

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