Organization Active NPI

Artisan Plastic Surgery, LLC

  • Specialist
  • Atlanta, GA
National Provider Identifier
1275738528
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
SBL010388 Issued in GA
Legal business name
ARTISAN PLASTIC SURGERY, LLC
Practice address
5670 Peachtree Dunwoody Rd
Ste 820
Atlanta, GA 30342-4717
Phone
(404) 851-1998
Fax
(404) 528-2886
NPI assigned
Jun 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Authorized official

Name
Dr. Diane Z. Alexander, M.D.NPI 1245354299
Title
Owner, Medical Doctor
Phone
(404) 857-1998

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)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X SBL010388 GA Primary

Addresses

Primary practice location

5670 Peachtree Dunwoody Rd
Ste 820
Atlanta, GA 30342-4717

Mailing address

5670 Peachtree Dunwoody Rd
Ste 820
Atlanta, GA 30342-4717
Phone (404) 851-1998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090710000394 GA Part B Supplier - Clinic/Group Practice 2062564719 Receives reassigned benefits from 2 practitioners
Practice locations: Atlanta, GA; Johns Creek, GA

National Provider Directory

National Provider Directory

Locations

11459 Johns Creek Pkwy
Ste 100
Johns Creek, GA 30097
Phone (770) 622-2488

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1275738528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5670 PEACHTREE DUNWOODY RD",
            "address_2": "STE 820",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424717",
            "telephone_number": "404-851-1998",
            "fax_number": "404-528-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5670 PEACHTREE DUNWOODY RD",
            "address_2": "STE 820",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424717",
            "telephone_number": "404-851-1998",
            "fax_number": "404-528-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARTISAN PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "Z.",
        "authorized_official_title_or_position": "OWNER, MEDICAL DOCTOR",
        "authorized_official_telephone_number": "404-857-1998",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "SBL010388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.

Verify at the official NPI Registry.