Westside Endoscopy Center PC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

033269 Issued in GA

Legal business name

WESTSIDE ENDOSCOPY CENTER PC

Practice address

3825 Medical Park Dr
Suite 300
Austell, GA 30106-1109

Phone

(678) 945-9600

Fax

(770) 948-9149

NPI assigned

Aug 24, 2005

Last updated

Mar 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Devon Spencer

Title

Manager

Phone

(770) 941-4810

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Westside Endoscopy CenterCCN 11C0001230

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

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709337600000",
    "number": "1487647483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 MEDICAL PARK DR",
            "address_2": "SUITE 300",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061109",
            "telephone_number": "678-945-9600",
            "fax_number": "770-948-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 MEDICAL PARK DR",
            "address_2": "SUITE 300",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061109",
            "telephone_number": "678-945-9600",
            "fax_number": "770-948-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE ENDOSCOPY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2024-03-02",
        "certification_date": "2024-03-02",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "DEVON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-941-4810"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "GA",
            "license": "033269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West Atlanta Endodontics
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• West Georgia Infectious Diseases
• Brandon D West, PA
• Westside Hospice & Palliative Care, LLC
• Zachary Richard Wetendorf, M.D.
• Raymond H Wexler, M.D.
• WF Thomas Drugs Inc
• Joy P Wharton

• Endoscopy Clinic/Center in Austell, GA
• Providers in Austell, GA by specialty
• Endoscopy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.