Northeast Georgia Surgical Assisting

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

NORTHEAST GEORGIA SURGICAL ASSISTING

Practice address

780 Hawkins Creek Dr
Jefferson, GA 30549-5416

Phone

(706) 870-1395

NPI assigned

Jan 15, 2019

Last updated

Jan 15, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Renah Gallagher, CSFANPI 1245706720

Title

Owner, Independent Csfa

Phone

(706) 870-1395

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Renah Elizabeth Gallagher, CSFA

  • Surgical Physician Assistant
  • Jefferson, GA
  • NPI 1245706720
  NPD (past) Authorized official

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1306310099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 HAWKINS CREEK DR",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305495416",
            "telephone_number": "706-870-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 HAWKINS CREEK DR",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305495416",
            "telephone_number": "706-870-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA SURGICAL ASSISTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "RENAH",
        "authorized_official_title_or_position": "OWNER, INDEPENDENT CSFA",
        "authorized_official_telephone_number": "706-870-1395",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CSFA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSFA CERTIFICATION NUMBER",
            "identifier": "186361",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MP Dental, LLC (Jefferson Dental Care)
• Kellie Brandenburg Mullins, PT
• Molly Musselwhite, PA-C
• William Robert Newell, DMD, PC
• Noah's Ark Homecare, Inc.
• Lauren Brennan Norwood, M.ED. CCC-SLP
• Cilleain S. O'Keeffe, OT
• Kaycie Oakley, OT
• Amber Brooke Ogden
• Malora Sharay Oglesby

• Surgical Physician Assistant in Jefferson, GA
• Providers in Jefferson, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.