NPIMap

Organization Active NPI

Northside Hospital, Inc.

Doing business as Northside/Dunwoody Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Atlanta, GA
National Provider Identifier
1386062255
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
044-281 Issued in GA
Legal business name
NORTHSIDE HOSPITAL, INC.
Doing business as
Northside/Dunwoody Surgery Center
Practice address
4553 N Shallowford Rd
Ste. 60-C
Atlanta, GA 30338-6408
Phone
(770) 455-1983
Fax
(770) 457-2823
NPI assigned
Mar 28, 2014
Last updated
Mar 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Authorized official

Name
Mr. Jorge J Hernandez
Title
VP/Chief Compliance Officer
Phone
(404) 851-6378

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 044-281 GA Primary

Addresses

Primary practice location

4553 N Shallowford Rd
Ste. 60-C
Atlanta, GA 30338-6408

Mailing address

1100 Johnson Ferry Rd
Centerpointe II, Ste 920
Atlanta, GA 30342-1709
Phone (404) 851-6378

Other names 1

  • Northside/Dunwoody Surgery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northside Hospital16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

1100 Johnson Ferry Rd
Ste 920
Sandy Springs, GA 30342

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1386062255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY RD",
            "address_2": "CENTERPOINTE II, STE 920",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-851-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4553 N SHALLOWFORD RD",
            "address_2": "STE. 60-C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386408",
            "telephone_number": "770-455-1983",
            "fax_number": "770-457-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-28",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP/CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "404-851-6378",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "044-281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northside/Dunwoody Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.