Organization Active NPI

Gwinnett Neurosurgical, PC

  • Neurological Surgery Physician
  • Lawrenceville, GA
National Provider Identifier
1407988702
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
GWINNETT NEUROSURGICAL, PC
Practice address
753 Old Norcross Rd
Suite a
Lawrenceville, GA 30045-4312
Phone
(770) 995-5333
Fax
(770) 995-5322
NPI assigned
Mar 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kevin L Anderson
Title
Manager of Patient Accounts
Phone
(770) 995-5333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X GA Primary

Addresses

Primary practice location

753 Old Norcross Rd
Suite a
Lawrenceville, GA 30045-4312

Mailing address

753 Old Norcross Rd
Suite a
Lawrenceville, GA 30045-4312
Phone (770) 995-5333

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407988702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 OLD NORCROSS RD",
            "address_2": "SUITE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300454312",
            "telephone_number": "770-995-5333",
            "fax_number": "770-995-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 OLD NORCROSS RD",
            "address_2": "SUITE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300454312",
            "telephone_number": "770-995-5333",
            "fax_number": "770-995-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT NEUROSURGICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER OF PATIENT ACCOUNTS",
        "authorized_official_telephone_number": "770-995-5333"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.