Organization Active NPI

Metro Atlanta Endoscopy LLC

  • Endoscopy Clinic/Center
  • Atlanta, GA
National Provider Identifier
1487617916
Registry record updated May 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
License
060223 Issued in GA
Legal business name
METRO ATLANTA ENDOSCOPY LLC
Practice address
5669 Peachtree Dunwoody Rd NE
Ste 210
Atlanta, GA 30342-1786
Phone
(404) 255-4333
Fax
(404) 255-0601
NPI assigned
Apr 7, 2006
Last updated
May 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2010

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

Authorized official

Name
Kathy Brown
Title
Manager
Phone
(404) 255-4333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X 060223 GA Primary

Addresses

Primary practice location

5669 Peachtree Dunwoody Rd NE
Ste 210
Atlanta, GA 30342-1786

Mailing address

5669 Peachtree Dunwoody Rd NE
Ste 210
Atlanta, GA 30342-1786
Phone (404) 255-4333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080603000226 GA Part B Supplier - Ambulatory Surgical Center 4284704271 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Metro Atlanta Endoscopy LLCCCN 11C0001193
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0987740Metro Atlanta Endoscopy LLC5669 Peachtree Dunwoody Rd Suite 210, Atlanta, GA 30342Certificate of waiverJun 12, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273190400000",
    "number": "1487617916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5669 PEACHTREE DUNWOODY RD NE",
            "address_2": "STE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421786",
            "telephone_number": "404-255-4333",
            "fax_number": "404-255-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5669 PEACHTREE DUNWOODY RD NE",
            "address_2": "STE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421786",
            "telephone_number": "404-255-4333",
            "fax_number": "404-255-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO ATLANTA ENDOSCOPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2010-05-07",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-255-4333"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "GA",
            "license": "060223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2010; 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.