Organization Active NPI

Woodstock Endoscopy Center

  • Endoscopy Clinic/Center
  • Woodstock, GA
National Provider Identifier
1063458909
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
Legal business name
WOODSTOCK ENDOSCOPY CENTER
Practice address
900 Towne Lake Pkwy Ste 310
Woodstock, GA 30189-1604
Phone
(770) 926-0771
Fax
(770) 926-9321
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Authorized official

Name
Amy E Fouts
Title
Chief Compliance Officer
Phone
(404) 851-6968

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X Primary

Addresses

Primary practice location

900 Towne Lake Pkwy Ste 310
Woodstock, GA 30189-1604

Mailing address

550 Peachtree St NE Ste 1600
Atlanta, GA 30308-2246
Phone (404) 888-7575

Other identifiers 1

IdentifierTypeStateIssuer
800348822AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090608000541 GA Part B Supplier - Ambulatory Surgical Center 4082764386 Practice locations: Woodstock, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Woodstock Endoscopy CenterCCN 11C0001212
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1063458909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE STE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082246",
            "telephone_number": "404-888-7575",
            "fax_number": "404-885-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TOWNE LAKE PKWY STE 310",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301891604",
            "telephone_number": "770-926-0771",
            "fax_number": "770-926-9321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSTOCK ENDOSCOPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "FOUTS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "404-851-6968"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800348822A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.