Surgical Center for Urology LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SURGICAL CENTER FOR UROLOGY LLC

Practice address

180 N Park TRL Ste 200
Stockbridge, GA 30281-7372

Phone

(678) 565-1806

Fax

(678) 565-1904

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Cheris L Craig

Title

Chief Administrative Officer

Phone

(770) 474-5281

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Surgical Center for Urology LLCCCN 11C0001279

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Morris Libby, MD

  • Urology Physician
  • Stockbridge, GA
  • NPI 1326146507
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1477651610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N PARK TRL STE 200",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817372",
            "telephone_number": "678-565-1806",
            "fax_number": "678-565-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N PARK TRL STE 200",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817372",
            "telephone_number": "678-565-1806",
            "fax_number": "678-565-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL CENTER FOR UROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "CHERIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "770-474-5281"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Darchell Sullivan, NP
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• Catrina Surrency
• Jeremy Surry, RBT
• M. Avigail Susson, P.T.
• Sasha E Sutcavage, AU.D.
• Sutton Orthopaedics & Sports Medicine PC

• Ambulatory Surgical Clinic/Center in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.