Gleneagles Surgery, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

026177 Issued in GA

Legal business name

GLENEAGLES SURGERY, PC

Doing business as

German M. Reyes, M.D.

Practice address

1215 Eagles Landing Pkwy
#105
Stockbridge, GA 30281-7279

Phone

(770) 506-2080

Fax

(770) 506-2767

NPI assigned

Jul 23, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Pia Berks

Title

Biller

Phone

(770) 506-2080

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• German M. Reyes, M.D. Doing business as

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1437170347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 EAGLES LANDING PKWY",
            "address_2": "#105",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817279",
            "telephone_number": "770-506-2080",
            "fax_number": "770-506-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 EAGLES LANDING PKWY",
            "address_2": "#105",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817279",
            "telephone_number": "770-506-2080",
            "fax_number": "770-506-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENEAGLES SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "BERKS",
        "authorized_official_first_name": "PIA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "770-506-2080",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "026177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00313288C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "German M. Reyes, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.