NPIMap

Organization Active NPI

Atlanta Plastic & Reconstructive Specialists, LLC

  • Plastic Surgery Physician
  • Atlanta, GA
National Provider Identifier
1164856647
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
ATLANTA PLASTIC & RECONSTRUCTIVE SPECIALISTS, LLC
Practice address
5673 Peachtree Dunwoody Rd
Suite 870
Atlanta, GA 30342-1731
Phone
(404) 255-2975
Fax
(404) 255-2276
NPI assigned
Sep 3, 2013
Last updated
Jul 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Authorized official

Name
Dr. Gregory J Mackay, MDNPI 1386686491
Title
Organizer/Manager
Phone
(404) 255-2975

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

5673 Peachtree Dunwoody Rd
Suite 870
Atlanta, GA 30342-1731

Mailing address

5673 Peachtree Dunwoody Rd
Suite 870
Atlanta, GA 30342-1731
Phone (404) 255-2975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131216000709 GA Part B Supplier - Clinic/Group Practice 3274760400 Receives reassigned benefits from 7 practitioners
Practice locations: Alpharetta, GA; Atlanta, GA

National Provider Directory

National Provider Directory

Locations

631 Professional Dr
Ste 240
Lawrenceville, GA 30046
Phone (706) 613-5171

Practitioners & affiliated clinicians

Practitioners 11

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": "1378166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1164856647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 870",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-255-2975",
            "fax_number": "404-255-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 870",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-255-2975",
            "fax_number": "404-255-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA PLASTIC & RECONSTRUCTIVE SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-03",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "MACKAY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ORGANIZER/MANAGER",
        "authorized_official_telephone_number": "404-255-2975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 20, 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.