JC Plastic Surgery of Atlanta, LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

63841 Issued in GA

Legal business name

JC PLASTIC SURGERY OF ATLANTA, LLC

Practice address

5505 Peachtree Dunwoody Rd
Suite 220
Atlanta, GA 30342-1705

Phone

(404) 312-3878

Fax

(404) 829-1312

NPI assigned

Mar 4, 2016

Last updated

Mar 4, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yeon-Jeen Chang, M.D.NPI 1245351600

Title

President

Phone

(404) 312-3878

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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.

• Yeon-Jeen Chang, M.D.

  • Surgery Physician
  • Southfield, MI
  • NPI 1245351600

  GA

  Medicare reassignment NPD Authorized official
• Lindsey Wong Webb, MD

  • Plastic and Reconstructive Surgery Physician
  • Atlanta, GA
  • NPI 1285869867
  NPD (past)

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1114387040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 220",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421705",
            "telephone_number": "404-312-3878",
            "fax_number": "404-829-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 220",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421705",
            "telephone_number": "404-312-3878",
            "fax_number": "404-829-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JC PLASTIC SURGERY OF ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "YEON-JEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-312-3878",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "GA",
            "license": "63841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jdonohue Enterprises, Inc. (BodyLogicMD or Atlanta/ Buckhead)
• Goun Je, MD
• Mirline Jean Baptiste
• Wilt-Line Jean Baptiste
• Michelet Jean Mary

• Plastic and Reconstructive Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Plastic and Reconstructive Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.