Georgia Urology PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

GEORGIA UROLOGY PA

Practice address

1301 Sigman Rd NE Ste 250a
Conyers, GA 30012

Phone

(770) 760-9900

Fax

(770) 760-1709

NPI assigned

Apr 15, 2007

Last updated

May 6, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

GEORGIA UROLOGY PAAs reported in NPPES

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

Authorized official

Name

Dan Fellner

Title

Ceo

Phone

(678) 205-8360

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Ga Urology ASC Canton

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

{
    "created_epoch": "1176595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1245455435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SIGMAN RD NE STE 250A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30012",
            "telephone_number": "770-760-9900",
            "fax_number": "770-760-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA UROLOGY PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA UROLOGY PA",
        "enumeration_date": "2007-04-15",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "FELLNER",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-205-8360"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "11D0949726",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Georgia Precision Imaging, LLC
• Georgia Urology Piedmont, LLC
• Georgia Urology, PA
• Yohannes Gari Gerba, PHARMD.
• Rebeca Gibbons, LPC
• Corey Dwayne Gibbs

• Urology Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.