Active NPI
Surgicare Plus LLC
- Anesthesiology Physician
- Loganville, GA
National Provider Identifier
1235541608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- SURGICARE PLUS LLC
- Practice address
- 367 Athens Hwy Ste 100D
Loganville, GA 30052-2204 - Phone
- (678) 466-6760
- NPI assigned
- May 20, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christopher Ibikunle
- Title
- Ceo
- Phone
- (678) 466-6760
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
367 Athens Hwy Ste 100D
Loganville, GA 30052-2204
Mailing address
367 Athens Hwy Ste 100D
Loganville, GA 30052-2204
Phone (678) 466-6760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
367 Athens Hwy
Ste 100D
Loganville, GA 30052
Phone (678) 466-6760
367 Athens Hwy
Ste 100C
Loganville, GA 30052
Phone (770) 580-4929
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Snellville, GA
- NPI 1962856351
-
- Acute Care Nurse Practitioner
- Braselton, GA
- NPI 1558816579
-
- Certified Registered Nurse Anesthetist
- Atlanta, GA
- NPI 1366772907
-
- Anesthesiology Physician
- Monroe, GA
- NPI 1801861158
-
- Certified Registered Nurse Anesthetist
- Snellville, GA
- NPI 1245523075
-
- Surgery Physician
- Loganville, GA
- NPI 1992981302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400544000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1400544000000",
"number": "1235541608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "367 ATHENS HWY STE 100D",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300522204",
"telephone_number": "678-466-6760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "367 ATHENS HWY STE 100D",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300522204",
"telephone_number": "678-466-6760"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SURGICARE PLUS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-05-20",
"last_updated": "2014-05-20",
"status": "A",
"authorized_official_last_name": "IBIKUNLE",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "678-466-6760"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.