Organization Active NPI

Urology of Greater Atlanta LLC

  • Specialist
  • Stockbridge, GA
National Provider Identifier
1669570990
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
UROLOGY OF GREATER ATLANTA LLC
Practice address
180 N Park TRL Ste 100
Stockbridge, GA 30281-7372
Phone
(770) 474-5281
Fax
(770) 389-8674
NPI assigned
Sep 20, 2006
Last updated
Oct 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
Ms. Cheris L Craig
Title
Executive Director
Phone
(770) 474-5281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

180 N Park TRL Ste 100
Stockbridge, GA 30281-7372

Mailing address

180 N Park TRL Ste 100
Stockbridge, GA 30281-7372
Phone (770) 474-5281

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050111000514 GA Part B Supplier - Clinic/Group Practice 5294783734 Receives reassigned benefits from 13 practitioners
Practice locations: Blue Ridge, GA; Stockbridge, GA; Griffin, GA; Covington, GA; Atlanta, GA

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
11D2050503Urology of Greater Atlanta, LLC180 North Park Trail, Suite 210, Stockbridge, GA 30281AccreditationJan 1, 2027
11D2151075Urology of Greater Atlanta, LLC180 North Park Trail, Suite 100, Stockbridge, GA 30281Provider-performed microscopyJul 10, 2028

National Provider Directory

National Provider Directory

Locations

550 Peachtree St NE
Ste 1265
Atlanta, GA 30308
Phone (404) 221-1095

36 Mulberry St
Ste 2
East Ellijay, GA 30540
Phone (706) 635-3630

685 S 9th St
Griffin, GA 30224

1502 W 3rd St
Ste B
Jackson, GA 30233
Phone (770) 775-0065

29 Upper Riverdale Rd SW
Ste 100
Riverdale, GA 30274
Phone (770) 907-1199

29 Upper Riverdale Rd SW
Ste 150
Riverdale, GA 30274
Phone (770) 907-1199

5673 Peachtree Dunwoody Rd
Ste 730
Sandy Springs, GA 30342
Phone (404) 943-0000

180 N Park Trl
Ste 210
Stockbridge, GA 30281

290 Country Club Dr
Ste 230
Stockbridge, GA 30281

290 Country Club Dr
Ste 240
Stockbridge, GA 30281
Phone (678) 565-1806

290 Country Club Dr
Ste 730
Stockbridge, GA 30281

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1669570990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N PARK TRL STE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817372",
            "telephone_number": "770-474-5281",
            "fax_number": "770-389-8674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N PARK TRL STE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817372",
            "telephone_number": "770-474-5281",
            "fax_number": "770-389-8674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY OF GREATER ATLANTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "CHERIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-474-5281",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.