Organization Active NPI

North Georgia Surgical Group LLC

  • Surgery Physician
  • Dalton, GA
National Provider Identifier
1700157880
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
020574 Issued in GA
Legal business name
NORTH GEORGIA SURGICAL GROUP LLC
Practice address
1504 N Thornton Ave
Suite 101B
Dalton, GA 30720-8394
Phone
(706) 278-0351
NPI assigned
Jan 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
William H Lumpkin, MD
Title
Sole MBR
Phone
(706) 278-0351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 020574 GA Primary

Addresses

Primary practice location

1504 N Thornton Ave
Suite 101B
Dalton, GA 30720-8394

Mailing address

1801 Huntington Woods Way
Dalton, GA 30720-3838
Phone (706) 248-0351

Other identifiers 3

IdentifierTypeStateIssuer
01281439OtherGAAMERIGROUP
N0503836OtherGAWELLCARE
000180353CMedicaidGA

National Provider Directory

National Provider Directory

Locations

1504 N Thornton Ave
Ste 101B
Dalton, GA 30720
Phone (706) 278-0351

NPI Registry JSON

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1700157880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 HUNTINGTON WOODS WAY",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203838",
            "telephone_number": "706-248-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 N THORNTON AVE",
            "address_2": "SUITE 101B",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208394",
            "telephone_number": "706-278-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GEORGIA SURGICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-20",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "LUMPKIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "706-278-0351",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "020574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01281439",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "N0503836",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000180353C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.