Organization Active NPI

North Atlanta Urology Assoc PC

  • Urology Physician
  • Lawrenceville, GA
National Provider Identifier
1184633778
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
NORTH ATLANTA UROLOGY ASSOC PC
Practice address
631 Professional Dr Ste 490
Lawrenceville, GA 30046
Phone
(770) 995-0424
Fax
(770) 513-7334
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Authorized official

Name
Ms. Dorothy E Wimmerstedt
Title
Office Manager
Phone
(770) 995-0424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X GA Primary

Addresses

Primary practice location

631 Professional Dr Ste 490
Lawrenceville, GA 30046

Mailing address

631 Professional Dr Ste 490
Lawrenceville, GA 30046-3370
Phone (770) 995-0424

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

631 Professional Dr
Ste 490
Lawrenceville, GA 30046
Phone (770) 963-8444

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1184633778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 490",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463370",
            "telephone_number": "770-995-0424",
            "fax_number": "770-513-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DR STE 490",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-995-0424",
            "fax_number": "770-513-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ATLANTA UROLOGY ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "WIMMERSTEDT",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-995-0424",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.