NPIMap

Organization Active NPI

Surgical Medical Associates

  • Physician Assistant
  • Conyers, GA
National Provider Identifier
1447419106
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
044534882 Issued in GA
Legal business name
SURGICAL MEDICAL ASSOCIATES
Practice address
1372 Wellbrook Cir NE
Conyers, GA 30012-3872
Phone
(770) 985-4257
NPI assigned
Jun 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Anne Grant, PA-C
Title
Ceo
Phone
(770) 985-4257

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 044534882 GA Primary

Addresses

Primary practice location

1372 Wellbrook Cir NE
Conyers, GA 30012-3872

Mailing address

PO Box 391824
Snellville, GA 30039-0031
Phone (770) 985-4257

National Provider Directory

National Provider Directory
Tax ID family
Surgical Medical Associate Corporation Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1447419106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 391824",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300390031",
            "telephone_number": "770-985-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1372 WELLBROOK CIR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123872",
            "telephone_number": "770-985-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-985-4257",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "044534882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.