Urology Surgery Center Johns Creek LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

UROLOGY SURGERY CENTER JOHNS CREEK LLC

Practice address

10730 Medlock Bridge Rd
Suite 120
Johns Creek, GA 30097-1705

Phone

(678) 344-8900

Fax

(678) 666-5201

NPI assigned

Jul 26, 2016

Organization subpart

No

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

Authorized official

Name

Beemal Shah

Title

Ceo

Phone

(706) 951-8657

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Urology Surgery Center Johns CreekCCN 11C0001467

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Advanced Urology Institute of Georgia

  • Urology Physician
  • Snellville, GA
  • NPI 1073896510

  Member Of

  NPD member

Locations

Practitioners 7

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

• Nicholas Farber, MD

  • Urology Physician
  • Johns Creek, GA
  • NPI 1952716730
  NPD (past)
• Lauren Goring

  • Surgical Physician Assistant
  • Johns Creek, GA
  • NPI 1619791456
  NPD (past)
• Timothy Casey McCullough, D.O.

  • Urology Physician
  • Johns Creek, GA
  • NPI 1881808947
  NPD (past)
• Neal Patel, M.D.

  • Urology Physician
  • Johns Creek, GA
  • NPI 1063723401
  NPD (past)
• Sanik J Patel, PA-C

  • Medical Physician Assistant
  • Dacula, GA
  • NPI 1487528691
  NPD (past)
• Mary Kathryn Peabody, PA-C

  • Surgical Physician Assistant
  • Johns Creek, GA
  • NPI 1609459577
  NPD (past)
• Nicole Schladt, PA-C

  • Surgical Physician Assistant
  • Johns Creek, GA
  • NPI 1720892649
  NPD (past)

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1124571104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 JANMAR RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785606",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10730 MEDLOCK BRIDGE RD",
            "address_2": "SUITE 120",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971705",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY SURGERY CENTER JOHNS CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BEEMAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-951-8657"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ulna Surgery Center LLC
• Danielle Taewon Um, MSN RN APRN AGPCNP-C
• Naveed Shaz Ummed, M.D
• Malvika Uppal, M.D.
• Upperhealth Wellness Center LLC
• Theresa Usta
• Dee Faucett Vallee, PHARMD
• Allison Elaine Van Camp, RD
• Daniela Vargas, DMD
• Jennifer Michele Varnado, SLP006625

• Ambulatory Surgical Clinic/Center in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.

Verify at the official NPI Registry.