Organization Active NPI

Alliance Surgery Center at Peachtree City LLC

  • Ambulatory Surgical Clinic/Center
  • Peachtree City, GA
National Provider Identifier
1598372963
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ALLIANCE SURGERY CENTER AT PEACHTREE CITY LLC
Practice address
1975 Highway 54 W Ste 105
Peachtree City, GA 30269-4794
Phone
(404) 920-4950
NPI assigned
Sep 29, 2020
Last updated
Sep 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Authorized official

Name
Victoria Beck
Title
Cfo
Phone
(404) 920-4950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1975 Highway 54 W Ste 105
Peachtree City, GA 30269-4794

Mailing address

3390 Peachtree Rd NE Ste 1500
Atlanta, GA 30326-2822
Phone (404) 920-4950

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210202001712 GA Part B Supplier - Ambulatory Surgical Center 4183038110 Practice locations: Peachtree City, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Alliance Surgery Center at Peachtree City LLCCCN 11C0001539
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
11D2197336Alliance Surgery Center at Peachtree City1975 Highway 54 W, Suite 105, Peachtree City, GA 30269Certificate of waiverOct 22, 2026

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1975 Highway 54 W
Ste 105
Peachtree Cty, GA 30269

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": "1601337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1598372963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 PEACHTREE RD NE STE 1500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303262822",
            "telephone_number": "404-920-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 HIGHWAY 54 W STE 105",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694794",
            "telephone_number": "404-920-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE SURGERY CENTER AT PEACHTREE CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "404-920-4950"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.