Active NPI
Robert A. Underwood, M.D.
- Surgery Physician
- Marietta, GA
National Provider Identifier
1063570521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 049950
- Practice address
- 598 Nancy St NW Ste 250
Marietta, GA 30060-1377 - Phone
- (770) 428-3713
- Fax
- (770) 426-0730
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 049950 | GA | Primary |
Addresses
Primary practice location
598 Nancy St NW Ste 250
Marietta, GA 30060-1377
Mailing address
598 Nancy St NW Ste 250
Marietta, GA 30060-1377
Phone (770) 428-3713
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00914999A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110706000276 | GA | Practitioner - General Surgery | 6103916770 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049950 | GA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Arts, P.C | Single Specialty | Current | Accepting new patients |
Locations
598 Nancy St NW
Ste 250
Marietta, GA 30060
Phone (770) 428-3713
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541030400000",
"number": "1063570521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "598 NANCY ST NW STE 250",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601377",
"telephone_number": "770-428-3713",
"fax_number": "770-426-0730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "598 NANCY ST NW STE 250",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601377",
"telephone_number": "770-428-3713",
"fax_number": "770-426-0730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "ROBERT",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2018-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": "GA",
"license": "049950",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00914999A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
- Deborah Aniekan Umoh
- Rekha Umoh, DNP
- Allyson Joy Underwood, FNP-BC
- Darian L. Underwood, OT
- Martavius Underwood, RBT
- Unfolding Evolution Healthcare
- Michael Thomas Unger, M.D.
- Sonia A Unigwe, NP
- Unihealth Solutions of North Georgia, Inc. (UniHealth Solutions of Cobb)
- Unihealth Solutions, Inc. (UniHealth Solutions of Cobb)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.