Georgia Urology PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

GEORGIA UROLOGY PA

Practice address

470 Northside Cherokee Blvd Ste 201
Canton, GA 30115-8015

Phone

(770) 720-7246

Fax

(770) 720-4620

NPI assigned

Apr 15, 2007

Organization subpart

Yes

Parent organization

GEORGIA UROLOGY PAAs reported in NPPES

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

Authorized official

Name

Dan Fellner

Title

Ceo

Phone

(678) 205-8360

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Georgia Urology

Locations

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

{
    "created_epoch": "1176595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1609091891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 NORTHSIDE CHEROKEE BLVD STE 201",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158015",
            "telephone_number": "770-720-7246",
            "fax_number": "770-720-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA UROLOGY PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA UROLOGY PA",
        "enumeration_date": "2007-04-15",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "FELLNER",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-205-8360"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "11D0943320",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgia Interventional Pain - E, LLC
• Georgia Mountain Endocrinology Corporation
• Georgia Neurobehavioral Associates, LLC
• Georgia Pain and Wellness Center, LLC
• Georgia Physician Associates, PC
• Georgia Urology PA
• Georgia Urology PA
• Georgia Urology, PA
• Georgia Urology, PA
• Georgia Urology, PA

• All providers in Canton, GA
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.