Douglas Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

019103 Issued in GA

Legal business name

DOUGLAS MEDICAL GROUP

Practice address

6025 Professional Pkwy
Suite 200
Douglasville, GA 30134-5609

Phone

(770) 949-0555

Fax

(770) 949-4424

NPI assigned

Mar 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Girish I Shroff, MD

Title

President

Phone

(770) 949-0555

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Shroff and Desai, M. D., P. C. Former legal business name

Practitioners 3

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

• Saurabh Desai, MD

  • Internal Medicine Physician
  • Douglasville, GA
  • NPI 1578626602
  NPD
• Lauren Cooper, DO

  • Family Medicine Physician
  • Douglasville, GA
  • NPI 1558066076
  NPD (past)
• Shiandra Rumph Thomas

  • Nurse Practitioner
  • Douglasville, GA
  • NPI 1093340457
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104886316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 PROFESSIONAL PKWY",
            "address_2": "SUITE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345609",
            "telephone_number": "770-949-0555",
            "fax_number": "770-949-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 PROFESSIONAL PKWY",
            "address_2": "SUITE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345609",
            "telephone_number": "770-949-0555",
            "fax_number": "770-949-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHROFF",
        "authorized_official_first_name": "GIRISH",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-949-0555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "019103",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "027530",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "038955",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "RN070145",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00305302B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shroff and Desai, M. D., P. C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Douglas County Retardation Association, Inc.
• Douglas County School System
• Douglas Dental Care LLC
• Douglas Dermatology and Skin Cancer Specialists LLC
• Douglas Hospital, Inc. (Wellstar Douglas Hospital)
• Douglas Medical Group
• Douglas Neurology Associates, P.C.
• Douglas Pediatrics Associates Inc. P.C. (d.b.a. Sand Hill Pediatrics)
• Douglasville Adent, LLC
• Douglasville Aim, LLC

• Specialist in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.