Rockdale Surgical Center

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

023925 Issued in GA

Legal business name

ROCKDALE SURGICAL CENTER

Practice address

4122 Tate St NE
Covington, GA 30014-2551

Phone

(770) 760-0182

Fax

(770) 483-3291

NPI assigned

Oct 31, 2007

Last updated

Jul 10, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

ROCKDALE SURGICAL CENTERAs reported in NPPES

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

Authorized official

Name

Lynwood CleavelandNPI 1457365736

Title

Doctor

Phone

(770) 760-0182

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Rockdale Surgical Ctr

Locations

Practitioners 2

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.

• Lynwood Paul Cleaveland, M.D.

  • Urology Physician
  • Covington, GA
  • NPI 1457365736
  Medicare reassignment NPD Authorized official
• Philip Garofano, FNP

  • Adult Health Nurse Practitioner
  • Marietta, GA
  • NPI 1851842652
  NPD

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1427237031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 TATE ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 TATE ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142551",
            "telephone_number": "770-760-0182",
            "fax_number": "770-483-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKDALE SURGICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROCKDALE SURGICAL CENTER",
        "enumeration_date": "2007-10-31",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "CLEAVELAND",
        "authorized_official_first_name": "LYNWOOD",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "770-760-0182"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "023925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00399506A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonja V Robinson
• Vanessa Robinson, CBD
• Rocdale Physician Practices, LLC (Premier Healthcare Alliance)
• Touris Rochelle, RN
• Rockdale Newton Hematology Oncology
• Ramiro Rodarte
• Quiana Chantelle Rodgers
• Rogers Hair Loss Center LLC
• Benjamin C Rogers, M.D.
• Dinisha C Rogers, RD,LD

• Urology Physician in Covington, GA
• Providers in Covington, GA by specialty
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.