Preston Gantt, MD, Sa-C

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PRESTON GANTT, MD, SA-C

Practice address

5330 Brookstone Dr NW Ste 250
Acworth, GA 30101-7183

Phone

(770) 580-4929

NPI assigned

Jul 5, 2018

Last updated

Apr 26, 2021By 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

Dr. Preston Gantt, MD, SA-CNPI 1902304538

Title

Owner

Phone

(770) 580-4929

Specialties & licenses 1

Addresses

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.

• Preston Gantt, MD, SA-C

  • Surgery Physician
  • Loganville, GA
  • NPI 1902304538
  Authorized official Same address or phone

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1366938086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 BROOKSTONE DR NW STE 250",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017183",
            "telephone_number": "770-580-4929",
            "fax_number": "949-561-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 BROOKSTONE DR NW STE 250",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017183",
            "telephone_number": "770-580-4929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Colbert",
            "state": "GA",
            "postal_code": "30628",
            "country_code": "US",
            "telephone_number": "770-580-4929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRESTON GANTT, MD, SA-C",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-05",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "GANTT",
        "authorized_official_first_name": "PRESTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-580-4929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, SA-C"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Adams Poteet, O.D.
• Fionna Elizabeth Powers, RBT
• Devin Prather
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• Premier Surgical Management LLC
• Lindsey Nicole Prewitt, MPT
• Rosaline Elizabeth Prince, OTR/L
• Procare Eye Center
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• Surgery Physician in Acworth, GA
• Providers in Acworth, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.