West Georgia Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

WEST GEORGIA SURGERY CENTER, LLC

Practice address

103 Clinic Ave,
Carrollton, GA 30117

Phone

(770) 853-7413

NPI assigned

Oct 12, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Greg Schulenburg

Title

Executive Vice President and Chief

Phone

(770) 853-7413

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

West Georgia Surgery Center LLCCCN 11C0001561

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Tanner Medical Center, Inc.

  dba Tanner Boutique

  • Durable Medical Equipment & Medical Supplies
  • Carrollton, GA
  • NPI 1104850965

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1023734084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CLINIC AVE,",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CLINIC AVE,",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117",
            "telephone_number": "770-853-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "SCHULENBURG",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT AND CHIEF",
        "authorized_official_telephone_number": "770-853-7413"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West Georgia Healthcare for Women, P.C.
• West Georgia Internal Medicine PC
• West Georgia Obstetrics & Gynecology P.C.
• West Georgia Pathology, LLC
• West Georgia Podiatry Assoc.
• West Georgia Urology Associates PC
• Lisa M West, RN
• WGG Anesthesia, LLC
• Wguas, LLC
• Wguasc, LLC

• Ambulatory Surgical Clinic/Center in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.