Active NPI
Taurek Erik-Soussi, CSA
- Surgical Physician Assistant
- Woodstock, GA
National Provider Identifier
1609166255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 3396
- Practice address
- 403 Woodchase Way
Woodstock, GA 30188-2052 - Phone
- (678) 956-1272
- NPI assigned
- Apr 17, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 3396 | GA | Primary |
Addresses
Primary practice location
403 Woodchase Way
Woodstock, GA 30188-2052
Mailing address
403 Woodchase Way
Woodstock, GA 30188-2052
Phone (678) 956-1272
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3396 | GA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1609166255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 WOODCHASE WAY",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301882052",
"telephone_number": "678-956-1272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 WOODCHASE WAY",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301882052",
"telephone_number": "678-956-1272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERIK-SOUSSI",
"first_name": "TAUREK",
"name_prefix": "Mr.",
"credential": "CSA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-17",
"last_updated": "2022-06-06",
"certification_date": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "GA",
"license": "3396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.