Atlas Surgery Center of Buckhead, Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

060-096 Issued in GA

Legal business name

ATLAS SURGERY CENTER OF BUCKHEAD, INC

Practice address

2045 Peachtree Rd NE Ste T1
Atlanta, GA 30309-1405

Phone

(786) 701-2225

Fax

(678) 412-1672

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Basille

Title

Owner

Phone

(678) 701-2225

Specialties & licenses 1

Addresses

Other names 1

• Roderique Surgi-Center, Inc. Former legal business name

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• Matthew Douglas Moore, BSN, RN

  • Administrator Registered Nurse
  • Dallas, GA
  • NPI 1043045537
  NPD
• Dawn Irene Bowen, OTR L CHT

  • Hand Occupational Therapist
  • Atlanta, GA
  • NPI 1245358209
  NPD (past)
• Jim W Roderique, M.D.

  • Orthopaedic Hand Surgery Physician
  • Atlanta, GA
  • NPI 1205857307
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617235200000",
    "number": "1215069166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 673363",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300060057",
            "telephone_number": "678-701-2225",
            "fax_number": "678-412-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 PEACHTREE RD NE STE T1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091405",
            "telephone_number": "786-701-2225",
            "fax_number": "678-412-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS SURGERY CENTER OF BUCKHEAD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "BASILLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-701-2225",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "060-096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roderique Surgi-Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in Atlanta, GA
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.