NPIMap

Organization Active NPI

CPM Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Austell, GA
National Provider Identifier
1376716316
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
033-382 Issued in GA
Legal business name
CPM SURGERY CENTER LLC
Practice address
3870 Medical Park Dr
Suite 100
Austell, GA 30106-1110
Phone
(770) 948-6824
Fax
(770) 948-6804
NPI assigned
Apr 10, 2008
Last updated
Jan 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Erin Sherrod
Title
Manager
Phone
(404) 920-4950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 033-382 GA Primary

Addresses

Primary practice location

3870 Medical Park Dr
Suite 100
Austell, GA 30106-1110

Mailing address

PO Box 11407 Dept 2440
Birmingham, AL 35246-2440
Phone (770) 929-9033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080818000131 GA Part B Supplier - Ambulatory Surgical Center 8820163454 Receives reassigned benefits from 9 practitioners
Practice locations: Austell, GA
O20110120001157 GA Part B Supplier - Clinic/Group Practice 6406035583 Receives reassigned benefits from 110 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Roswell, GA; Marietta, GA; Lawrenceville, GA; Douglasville, GA; Dallas, GA; Covington, GA; Conyers, GA; Carrollton, GA…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
CPM Sugery Center PCCCN 11C0001317
Medicare certification status
ActiveFrom the Provider of Services file

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
11D1084463CPM Surgery Center ,LLC3870 Medical Park Drive Suite 100, Austell, GA 30106Certificate of waiverMay 22, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3870 Medical Park Dr
Ste 100
Austell, GA 30106

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1376716316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DEPT 2440",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352462440",
            "telephone_number": "770-929-9033",
            "fax_number": "770-929-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3870 MEDICAL PARK DR",
            "address_2": "SUITE 100",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061110",
            "telephone_number": "770-948-6824",
            "fax_number": "770-948-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPM SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "SHERROD",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-920-4950"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "033-382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.