NPIMap

Organization Active NPI

Lakeshore Tubal Reversal Center

Doing business as Lakeshore Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Gainesville, GA
National Provider Identifier
1457425159
Registry record updated Mar 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
GA LIC 022231 Issued in GA
Legal business name
LAKESHORE TUBAL REVERSAL CENTER
Doing business as
Lakeshore Surgical Center
Practice address
2320 Limestone Parkway
Gainesville, GA 30501
Phone
(877) 588-5594
Fax
(770) 531-0053
NPI assigned
Nov 17, 2006
Last updated
Mar 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2009

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

Authorized official

Name
Ms. Cecilia Ashleigh Bates
Title
Office Manager
Phone
(770) 531-1181

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X DEA AG5691452 GA
Ambulatory Surgical Clinic/Center 261QA1903X GA LIC 022231 GA Primary

Addresses

Primary practice location

2320 Limestone Parkway
Gainesville, GA 30501

Mailing address

2320 Limestone Parkway
Gainesville, GA 30501
Phone (877) 588-5594

Other names 1

  • Lakeshore Surgical Center Doing business as

National Provider Directory

National Provider Directory

Locations

2320 Limestone Pkwy
Gainesville, GA 30501
Phone (770) 531-1181

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": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236643200000",
    "number": "1457425159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 LIMESTONE PARKWAY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "877-588-5594",
            "fax_number": "770-531-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 LIMESTONE PARKWAY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "877-588-5594",
            "fax_number": "770-531-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE TUBAL REVERSAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-03-10",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_middle_name": "ASHLEIGH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-531-1181",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "DEA AG5691452",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "GA LIC 022231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeshore Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; 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.