Eastside Endoscopy Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EASTSIDE ENDOSCOPY CENTER LLC

Practice address

1805 Honey Creek CMNS SE
Conyers, GA 30013-5828

Phone

(404) 509-1868

NPI assigned

Apr 21, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Karim Shakoor, MDNPI 1952412579

Title

Medical Director

Phone

(770) 922-7000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Eastside Endoscopy Center LLCCCN 11C0001471

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karim K Shakoor, M.D.

  • Gastroenterology Physician
  • Conyers, GA
  • NPI 1952412579
  NPD Authorized official
• Mirza A Kajani, M.D.

  • Gastroenterology Physician
  • Griffin, GA
  • NPI 1306975651
  NPD

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566259200000",
    "number": "1053846592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 HONEY CREEK CMNS SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300135828",
            "telephone_number": "404-509-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HONEY CREEK CMNS SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300135828",
            "telephone_number": "404-509-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-21",
        "last_updated": "2019-08-20",
        "status": "A",
        "authorized_official_last_name": "SHAKOOR",
        "authorized_official_first_name": "KARIM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-922-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Metro Emt Services LLC
• East Metro Internal Medicine
• East Metro Wellness Center, LLC
• Eastern Health Center PC
• Eastmetro Eyecare P.C.
• Eastside Endoscopy Center, LLC
• Eastside Endoscopy Center, LLC
• Eastside Internal Medicine, LLC
• Eastside Internal Medicine, LLC
• Eastside Premier Nephrology & Hypertension PC

• Ambulatory Surgical Clinic/Center in Conyers, GA
• Providers in Conyers, 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 Aug 20, 2019; 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.