Atlanta Reconstructive Surgery LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

066421 Issued in GA

Legal business name

ATLANTA RECONSTRUCTIVE SURGERY LLC

Practice address

1218 W Paces Ferry Rd NW
Suite 204
Atlanta, GA 30327-2308

Phone

(855) 363-3245

Fax

(718) 672-3280

NPI assigned

Aug 28, 2014

Last updated

Jul 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Shih, M.D.

Title

Owner

Phone

(443) 939-4050

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1033519970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2870 PEACHTREE RD NW STE 188",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052918",
            "telephone_number": "443-939-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 W PACES FERRY RD NW",
            "address_2": "SUITE 204",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303272308",
            "telephone_number": "855-363-3245",
            "fax_number": "718-672-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA RECONSTRUCTIVE SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-28",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "SHIH",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-939-4050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "GA",
            "license": "066421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.