Active NPI
South Georgia Urology Surgery Center, LLC
- Ambulatory Surgical Clinic/Center
- Albany, GA
National Provider Identifier
1285976241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- SOUTH GEORGIA UROLOGY SURGERY CENTER, LLC
- Practice address
- 803 N Jackson St Ste B
Albany, GA 31701-2313 - Phone
- (229) 431-2260
- NPI assigned
- Mar 18, 2013
- 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
- Dr. Rex O Ajayi, MD
- Title
- Owner
- Phone
- (229) 435-0832
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
803 N Jackson St Ste B
Albany, GA 31701-2313
Mailing address
803 N Jackson St Ste B
Albany, GA 31701-2313
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Ambulatory surgical center certification: CCN 11C0001402
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- SOUTH GEORGIA UROLOGY SURGERY CENTER, LLC
- Certification status
- Active
- Provider type (POS)
- Ambulatory surgical center
- Participating since
- Oct 14, 2013
- Last certification
- Aug 20, 2019
- Ownership / control type
- Proprietary
- Facility address
- 803 N Jackson Street
Albany, GA 31701
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363564800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1363564800000",
"number": "1285976241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "803 N JACKSON ST STE B",
"city": "ALBANY",
"state": "GA",
"postal_code": "317012313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 N JACKSON ST STE B",
"city": "ALBANY",
"state": "GA",
"postal_code": "317012313",
"telephone_number": "229-431-2260"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH GEORGIA UROLOGY SURGERY CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-18",
"last_updated": "2013-03-18",
"status": "A",
"authorized_official_last_name": "AJAYI",
"authorized_official_first_name": "REX",
"authorized_official_middle_name": "O",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "229-435-0832",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
- South Ga Family Care LLC
- South Georgia Neuropsychological Associates
- South Georgia Physical Therapy LLC
- South Georgia Sleep Professionals, LLC
- South Georgia Urology Clinic, P.C.
- South West Georgia Behavioral Health Provider Services Inc.
- Southern Diagnostic Services, Inc.
- Southern Family Markets LLC (Southern Family Market)
- Southern Home Care
- Southern Home Care Services, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.