NPIMap

Organization Active NPI

Dpi of Georgia, LLC

  • Anesthesiology Physician
  • Roswell, GA
National Provider Identifier
1407323199
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
DPI OF GEORGIA, LLC
Practice address
300 Colonial Center Pkwy Ste 100N
Roswell, GA 30076-4892
Phone
(225) 923-0030
Fax
(225) 923-0060
NPI assigned
Oct 31, 2018
Last updated
Oct 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Authorized official

Name
Dr. Scott Patrick Gardiner, MDNPI 1548299001
Title
Owner
Phone
(225) 923-0030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

300 Colonial Center Pkwy Ste 100N
Roswell, GA 30076-4892

Mailing address

8946 Interline Ave Ste C
Baton Rouge, LA 70809-1913
Phone (225) 923-0030

Other names 1

  • Diversified Professionals Inc Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190111001990 GA Part B Supplier - Clinic/Group Practice 0941546923 Receives reassigned benefits from 84 practitioners
Practice locations: Atlanta, GA; Cartersville, GA; Elberton, GA; Roswell, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 85

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 85

NPI Registry JSON

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1407323199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8946 INTERLINE AVE STE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708091913",
            "telephone_number": "225-923-0030",
            "fax_number": "225-923-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COLONIAL CENTER PKWY STE 100N",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764892",
            "telephone_number": "225-923-0030",
            "fax_number": "225-923-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DPI OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "GARDINER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-923-0030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diversified Professionals Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.