NPIMap

Organization Active NPI

Augusta Urology Associates, LLC

  • Specialist
  • Evans, GA
National Provider Identifier
1366511834
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
AUGUSTA UROLOGY ASSOCIATES, LLC
Practice address
4350 Towne Centre Dr Ste 2200
Evans, GA 30809-3346
Phone
(706) 722-0705
Fax
(706) 993-1284
NPI assigned
Nov 7, 2006
Last updated
Apr 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Authorized official

Name
Mr. Anissa Cooper
Title
Administrator
Phone
(706) 722-0705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

4350 Towne Centre Dr Ste 2200
Evans, GA 30809-3346

Mailing address

4350 Towne Centre Dr Ste 2200
Evans, GA 30809-3346
Phone (706) 722-0705

Other practice location 1

818 Saint Sebastian Way
Professional Bldg. 2, Suite 403
Augusta, GA 30901-2651
Phone (706) 722-0705

Other identifiers 1

IdentifierTypeStateIssuer
300033214GMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071106000068 GA Part B Supplier - Clinic/Group Practice 9234226440 Receives reassigned benefits from 10 practitioners
Practice locations: Evans, GA

National Provider Directory

National Provider Directory

Locations

818 Saint Sebastian Way
Ste 403
Augusta, GA 30901
Phone (706) 722-0705

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.190

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743724800000",
    "number": "1366511834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTRE DR STE 2200",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093346",
            "telephone_number": "706-722-0705",
            "fax_number": "706-312-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTRE DR STE 2200",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093346",
            "telephone_number": "706-722-0705",
            "fax_number": "706-993-1284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "818 Saint Sebastian Way",
            "address_2": "Professional Bldg. 2, Suite 403",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309012651",
            "country_code": "US",
            "telephone_number": "706-722-0705",
            "fax_number": "706-312-3026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUGUSTA UROLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "ANISSA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "706-722-0705",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300033214G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; 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.