Celestial Plastic and Reconstructive Surgery

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

CELESTIAL PLASTIC AND RECONSTRUCTIVE SURGERY

Practice address

2230 Godby Rd
College Park, GA 30349-5002

Phone

(404) 268-0828

Fax

(404) 393-1695

NPI assigned

Feb 28, 2018

Last updated

Jun 1, 2022By 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

Dr. Ruth Celestin, MDNPI 1972708899

Title

Plastic Surgeon, Owner

Phone

(770) 845-0696

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Celestial Plastic Surgery Other name

Locations

Practitioners 1

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.

• Ruth Celestin, MD

  • Plastic Surgery Physician
  • Riverdale, GA
  • NPI 1972708899
  Authorized official Same address or phone

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1619479201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 MARKETPLACE BLVD STE 130-559",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303445747",
            "telephone_number": "770-845-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 GODBY RD",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495002",
            "telephone_number": "404-268-0828",
            "fax_number": "404-393-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELESTIAL PLASTIC AND RECONSTRUCTIVE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-28",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "CELESTIN",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "PLASTIC SURGEON, OWNER",
        "authorized_official_telephone_number": "770-845-0696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "70539",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIROAD MEDICARE PTAN",
            "identifier": "DZ9723",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972708899",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003211917A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Celestial Plastic Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Plastic and Reconstructive Surgery Physician in College Park, GA
• Providers in College Park, GA by specialty
• Plastic and Reconstructive Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.

Verify at the official NPI Registry.