Active NPI
Woodstock Endoscopy Center
- Endoscopy Clinic/Center
- Woodstock, GA
National Provider Identifier
1063458909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endoscopy Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 800348822A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Center
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Canton, GA
- NPI 1770112021
Member Of
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Atlanta, GA
- NPI 1538143847
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.