Northeast Georgia Specialty Group LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NORTHEAST GEORGIA SPECIALTY GROUP LLC

Doing business as

Neurology Physician Group and Advantage Sports Medicine

Practice address

601 S Enota Dr NE
Suite Q
Gainesville, GA 30501-2400

Phone

(770) 533-8400

Fax

(770) 533-8409

NPI assigned

Aug 23, 2007

Last updated

Apr 28, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

NORTHEAST GEORGIA PRIMARY CARE, INC.As reported in NPPES

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

Authorized official

Name

Mark Klein

Title

Executive Director

Phone

(770) 533-8406

Specialties & licenses 8

Addresses

Other names 1

• Neurology Physician Group and Advantage Sports Medicine Doing business as

Part of

Northeast Georgia Prim

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Northeast Georgia Physicians Group, Inc.

  dba Medical Transport

  • Land Ambulance
  • Gainesville, GA
  • NPI 1538103049

  Member Of

  NPD member

Locations

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.

• Hector Gotay, M.D.

  • Neurology Physician
  • Gainesville, GA
  • NPI 1447250048
  NPD (past)

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1447443387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S ENOTA DR NE",
            "address_2": "SUITE Q",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012400",
            "telephone_number": "770-533-8400",
            "fax_number": "770-533-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S ENOTA DR NE",
            "address_2": "SUITE Q",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012400",
            "telephone_number": "770-533-8400",
            "fax_number": "770-533-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA SPECIALTY GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST GEORGIA PRIMARY CARE, INC.",
        "enumeration_date": "2007-08-23",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-533-8406"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neurology Physician Group and Advantage Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Northeast Georgia Physicians Group, Inc.
• Northeast Georgia Plastic Surgery
• Northeast Georgia Plastic Surgery Associates, Plastic Surgery Center
• Northeast Georgia Podiatry LLC
• Northeast Georgia Rehabilitation Hospital LLC (Northeast Georgia Rehabilitation Institute)
• Northeast Georgia Speech Center, Inc.
• Northeast Georgia Surgery Center
• Northeast Georgia Surgical Associates PC
• Northeast Georgia Urological Assoc., P.C.
• Northeast Georgia Urological Surgery Center, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.