Prologue Surgical Assisting, LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

PROLOGUE SURGICAL ASSISTING, LLC

Practice address

3493 Lower Burris Rd
Canton, GA 30114

Phone

(770) 331-4217

NPI assigned

Aug 8, 2017

Organization subpart

No

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

Authorized official

Name

Terri Rybak, CSFANPI 1740599182

Title

Certified Surgical First Assistant

Phone

(770) 331-4217

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.

• Terri Rybak, CST/CSFA

  • Surgical Physician Assistant
  • Canton, GA
  • NPI 1740599182

  Multi-Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1407371768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3493 LOWER BURRIS RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301144755",
            "telephone_number": "770-331-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3493 LOWER BURRIS RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "770-331-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLOGUE SURGICAL ASSISTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RYBAK",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "CERTIFIED SURGICAL FIRST ASSISTANT",
        "authorized_official_telephone_number": "770-331-4217",
        "authorized_official_credential": "CSFA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Canton, GA
• Providers in Canton, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.