Urological Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

052565 Issued in GA

Legal business name

UROLOGICAL SURGICAL CENTER LLC

Practice address

102 Hickory St
Warner Robins, GA 31093-3047

Phone

(478) 333-6961

NPI assigned

Dec 7, 2011

Organization subpart

No

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

Authorized official

Name

Melvin Lee Christopher Fussell, M.D.NPI 1699713594

Title

Owner/Board Certified Urologist

Phone

(478) 333-6961

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Urological Surgical Center LLCCCN 11C0001387

Locations

Practitioners 1

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

• Melvin Lee Christopher Fussell, M.D.

  • Urology Physician
  • Warner Robins, GA
  • NPI 1699713594
  NPD Authorized official

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1134497910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5098",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310105098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HICKORY ST",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933047",
            "telephone_number": "478-333-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGICAL SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "FUSSELL",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "LEE CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER/BOARD CERTIFIED UROLOGIST",
        "authorized_official_telephone_number": "478-333-6961",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "052565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Usmedx, LLC
• Amber Van Atta, OTA
• Mavis B Vanbibber, LCSW
• Dale Vance, FNP
• Linda Vanosdol, NP

• Ambulatory Surgical Clinic/Center in Warner Robins, GA
• Providers in Warner Robins, 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 Dec 7, 2011; 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.