NPIMap

Organization Active NPI

Georgia Urology, PA

  • Urology Physician
  • Buford, GA
National Provider Identifier
1295550010
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
GEORGIA UROLOGY, PA
Practice address
4745 Nelson Brogdon Blvd Ste 300
Buford, GA 30518-3714
Phone
(678) 205-8387
NPI assigned
Nov 18, 2024
Organization subpart
Yes
Parent organization
GEORGIA UROLOGY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

4745 Nelson Brogdon Blvd Ste 300
Buford, GA 30518-3714

Mailing address

1930 Brannan Rd
McDonough, GA 30253-4310
Phone (678) 284-4040

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2314900Georgia Urology Buford4745 Nelson Brogdon Boulevard, Suite 300, Buford, GA 30518Provider-performed microscopyDec 2, 2026

National Provider Directory

National Provider Directory
Tax ID family
Georgia Urology53 organizations share this tax ID, including this one
Part of
Georgia Urology

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1295550010",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 NELSON BROGDON BLVD STE 300",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305183714",
            "telephone_number": "678-205-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA UROLOGY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA UROLOGY, PA",
        "enumeration_date": "2024-11-18",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

  • 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.
  • 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.