Peachtree Surgical & Bariatrics

Primary specialty

SpecialistTaxonomy code 174400000X

License

056640 Issued in GA

Legal business name

PEACHTREE SURGICAL & BARIATRICS

Practice address

315 Boulevard NE
Suite 224
Atlanta, GA 30312-1200

Phone

(404) 881-8020

NPI assigned

Feb 9, 2007

Last updated

Aug 22, 2020By 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

Donald Kirk

Title

Administrative Director

Phone

(678) 553-3166

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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.

• Elaine Rose Carelus, M.D.

  • Surgery Physician
  • Atlanta, GA
  • NPI 1205367844
  Medicare reassignment Care Compare group NPD
• Titus D Duncan, M.D.

  • Specialist
  • Atlanta, GA
  • NPI 1366480402
  Medicare reassignment Care Compare group NPD
• Alexander Gonzalez-Jacobo, D.O.

  • Surgery Physician
  • Atlanta, GA
  • NPI 1457701542

  Single Specialty

  Medicare reassignment NPD
• Karleena Regina-Marie Tuggle, M.D.

  • Surgery Physician
  • Atlanta, GA
  • NPI 1467609107
  Medicare reassignment NPD
• Hernan Dario Urrego, MD

  • Surgery Physician
  • Duluth, GA
  • NPI 1316107253
  Medicare reassignment NPD
• Mustafa Kamari Davis, M.D.

  • Surgery Physician
  • Kingman, AZ
  • NPI 1891967444

  GA

  Medicare reassignment NPD
• Larry L Hobson, M.D.

  • Surgery Physician
  • Atlanta, GA
  • NPI 1235177387

  Specialist

  NPD (past)
• Jacqueline White Miller, M.D.

  • Surgery Physician
  • Decatur, GA
  • NPI 1992810246
  NPD (past)
• Andre L Scott, M.D.

  • Surgery Physician
  • Lithonia, GA
  • NPI 1033131396
  NPD (past)
• Francine R. Fields, M.D.

  • Family Medicine Physician
  • Chambersburg, PA
  • NPI 1427260199
  NPD (past)
• Tihesha L Wilson, MD

  • Surgery Physician
  • Miami, FL
  • NPI 1013997162
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386785780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE",
            "address_2": "SUITE 224",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121200",
            "telephone_number": "404-881-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE",
            "address_2": "SUITE 224",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121200",
            "telephone_number": "404-881-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE SURGICAL & BARIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "678-553-3166"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "056640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peachtree Smiles II PC (peachtree Smiles)
• Peachtree Spine & Pain Physicians
• Peachtree Spine & Pain Physicians ASC, LLC (Optimum Surgery Center)
• Peachtree Spine & Pain Physicians, Inc (Peachtree Spine Physicians, Inc)
• Peachtree Spine Center
• Peachtree Surgical Specialists P.C.
• Peachtree Urology, PC
• Peachtree Vascular Associates, P.C.
• Peachtree Wellness Center, PC
• Peachtree Women's Clinic 2 LLC

• Specialist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.