North Atlanta Ear, Nose & Throat Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NORTH ATLANTA EAR, NOSE & THROAT SURGICAL CENTER, LLC

Practice address

4150 Deputy Bill Cantrell Memorial Rd
Ste 160
Cumming, GA 30040

Phone

(470) 297-0257

Fax

(770) 292-3046

NPI assigned

Aug 23, 2017

Last updated

May 19, 2021By 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

Sheree Moon

Title

Practice Administrator

Phone

(470) 297-1123

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

North Atlanta Ear Nose and Throat Surgical Center LLCCCN 11C0001486

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 4

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.

• Joel A. Hoffman, M.D.

  • Otolaryngology Physician
  • Cumming, GA
  • NPI 1639178486
  NPD
• Mark B Vandeusen, M.D.

  • Otolaryngology Physician
  • Cumming, GA
  • NPI 1225271018
  NPD
• Hafiah Eltahir, DO

  • Otolaryngology Physician
  • Cumming, GA
  • NPI 1316443328
  NPD (past)
• Preston Leigh Imhof, D.O.

  • Otolaryngology Physician
  • Cumming, GA
  • NPI 1700042132
  NPD (past)

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1639696529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 DEPUTY BILL CANTRELL MEMORIAL RD.",
            "address_2": "SUITE 160",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "470-297-0257",
            "fax_number": "770-292-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 DEPUTY BILL CANTRELL MEMORIAL RD",
            "address_2": "STE 160",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "470-297-0257",
            "fax_number": "770-292-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ATLANTA EAR, NOSE & THROAT SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-23",
        "last_updated": "2021-05-19",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "SHEREE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "470-297-1123"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Michelle Nollenberger, LPC
• Taila-Imani Gwenyth Norenberg
• Kathleen Norris
• North Atlanta Cardiology PC
• North Atlanta Ear Nose & Throat PC
• North Atlanta Eye Surgery Center LLC
• North Atlanta Family Eye Care, Inc.
• North Atlanta Family Practice, LLC
• North Atlanta Hearing LLC
• North Atlanta Heart & Vascular Centre

• Ambulatory Surgical Clinic/Center in Cumming, GA
• Providers in Cumming, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.