Organization Active NPI

Surgical Health Collective

  • Specialist
  • Atlanta, GA
National Provider Identifier
1063714814
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
026953 Issued in GA
Legal business name
SURGICAL HEALTH COLLECTIVE
Practice address
777 Cleveland Ave SW
Suite 305
Atlanta, GA 30315-7129
Phone
(404) 761-7482
NPI assigned
Nov 30, 2010
Last updated
Nov 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Dr. Mark Lamont Walker, M.D.NPI 1356382345
Title
Medical Director
Phone
(404) 761-7482

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 026953 GA Primary

Addresses

Primary practice location

777 Cleveland Ave SW
Suite 305
Atlanta, GA 30315-7129

Mailing address

777 Cleveland Ave SW
Suite 305
Atlanta, GA 30315-7129
Phone (404) 761-7482

Other identifiers 1

IdentifierTypeStateIssuer
000298284EMedicaidGA

National Provider Directory

National Provider Directory

Locations

1691 Phoenix Blvd
Ste 120
Atlanta, GA 30349
Phone (404) 761-7482

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1063714814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CLEVELAND AVE SW",
            "address_2": "SUITE 305",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157129",
            "telephone_number": "404-761-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CLEVELAND AVE SW",
            "address_2": "SUITE 305",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157129",
            "telephone_number": "404-761-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL HEALTH COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LAMONT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "404-761-7482",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "026953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000298284E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.