Medici Surgical Center Gwinnett, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MEDICI SURGICAL CENTER GWINNETT, LLC

Practice address

2220 Wisteria Dr Ste 100
Snellville, GA 30078-4604

Phone

(844) 328-4624

Fax

(770) 882-2576

NPI assigned

Apr 21, 2020

Last updated

May 27, 2020By 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

Sonny Dosanjh, MDNPI 1952596850

Title

Cmo, Owner

Phone

(844) 328-4624

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Medici Surgical Center Gwinnett LLCCCN 11C0001536

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Sonny Sandeep Singh Dosanjh, MD

  • Physical Medicine & Rehabilitation Physician
  • Kennesaw, GA
  • NPI 1952596850
  NPD Authorized official
• Courtney Nicole Reina, FNP

  • Family Nurse Practitioner
  • Kennesaw, GA
  • NPI 1376358242
  NPD (past)
• Paul King White, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Stockbridge, GA
  • NPI 1225355993
  NPD (past)

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1699395541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 GEORGE BUSBEE PKWY NW STE 50",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446910",
            "telephone_number": "844-328-4624",
            "fax_number": "770-882-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 WISTERIA DR STE 100",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300784604",
            "telephone_number": "844-328-4624",
            "fax_number": "770-882-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICI SURGICAL CENTER GWINNETT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "DOSANJH",
        "authorized_official_first_name": "SONNY",
        "authorized_official_title_or_position": "CMO, OWNER",
        "authorized_official_telephone_number": "844-328-4624",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Marie McPhail
• Brian J Meadows
• Medequip Inc
• Medequip Plus, LLC
• Medical & Sports Rehabilitation Assoc. Inc
• Medikwip, LLC
• Medipx, LLC (mediPx)
• Medmart Plus LLC
• Peter L Meehan, MD
• Mel Vision LLC (My EyeLab)

• Ambulatory Surgical Clinic/Center in Snellville, GA
• Providers in Snellville, 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 27, 2020; 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.