Celebrity Body Sculpting and Cosmetic Surgery Center

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

CELEBRITY BODY SCULPTING AND COSMETIC SURGERY CENTER

Practice address

4550 Jonesboro Rd
Suite K
Union City, GA 30291-2050

Phone

(678) 515-4607

Fax

(470) 355-8524

NPI assigned

Jun 16, 2016

Organization subpart

No

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

Authorized official

Name

Anishua M Roberts

Title

Operations Manager

Phone

(678) 515-4607

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1710337134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 JONESBORO RD",
            "address_2": "SUITE K",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912050",
            "telephone_number": "678-515-4607",
            "fax_number": "470-355-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 JONESBORO RD",
            "address_2": "SUITE K",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912050",
            "telephone_number": "678-515-4607",
            "fax_number": "470-355-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELEBRITY BODY SCULPTING AND COSMETIC SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "ANISHUA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "678-515-4607"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Union City, GA
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• 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 16, 2016; 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.