Gwinnett Endoscopy Center, PC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

Legal business name

GWINNETT ENDOSCOPY CENTER, PC

Practice address

301 Philip Blvd
Suite B
Lawrenceville, GA 30046-8745

Phone

(770) 822-5562

Fax

(770) 338-0510

NPI assigned

Jun 21, 2006

Organization subpart

No

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

Authorized official

Name

Jana Baker

Title

Administrator

Phone

(404) 888-7575

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Gwinnett Endoscopy Center PCCCN 11C0001055

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

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

• Northside Hospital, Inc.

  dba Northside Hospital Cherokee 'A Wellness Place'

  • Durable Medical Equipment & Medical Supplies
  • Canton, GA
  • NPI 1770112021

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1194761908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "address_2": "SUITE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082208",
            "telephone_number": "404-888-7575",
            "fax_number": "404-885-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PHILIP BLVD",
            "address_2": "SUITE B",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468745",
            "telephone_number": "770-822-5562",
            "fax_number": "770-338-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT ENDOSCOPY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "404-888-7575"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00587298A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gwinnett Drugs LLC
• Gwinnett Drugs LLC
• Gwinnett Emergency Specialists Observation Services, LLC
• Gwinnett Emergency Specialists, LLC
• Gwinnett Emergency Specialists, P.C.
• Gwinnett Family Dental Care
• Gwinnett Family Medicine
• Gwinnett Family Medicine and Geriatrics
• Gwinnett General Medicine
• Gwinnett Gynecology and Obstetrics

• Endoscopy Clinic/Center in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Endoscopy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.