Plastic Surgery Center of the South

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

261QA1903X Issued in GA

Legal business name

PLASTIC SURGERY CENTER OF THE SOUTH

Practice address

120 Vann St NE
Suite 150
Marietta, GA 30060-7250

Phone

(772) 421-1242

Fax

(770) 424-6652

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. James Edgar Leake, M.D.

Title

Medical Director

Phone

(770) 421-1242

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295885465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 VANN ST NE",
            "address_2": "SUITE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607250",
            "telephone_number": "772-421-1242",
            "fax_number": "770-424-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 VANN ST NE",
            "address_2": "SUITE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607250",
            "telephone_number": "772-421-1242",
            "fax_number": "770-424-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY CENTER OF THE SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEAKE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "EDGAR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-421-1242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "261QA1903X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PK Dental
• Joao MC-Oneil Nicolas Moise Plancher, M.D.
• Planted in Nutrition, LLC
• Cory Plasker, DC
• Eric H Plasker, DC
• Plasticity Centers of Georgia, LLC
• Inessa L Plavnik, DMD
• Kayli Elyse Pledger, BCBA
• Michael Poblet
• Merab Anyango Poche, CNA

• Clinic/Center in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.