NPIMap

Organization Active NPI

Northside Plastic Surgery

  • Plastic Surgery Physician
  • Roswell, GA
National Provider Identifier
1740245950
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
NORTHSIDE PLASTIC SURGERY
Practice address
1265 Upper Hembree Rd
Ste 100
Roswell, GA 30076-1143
Phone
(770) 751-1433
Fax
(770) 751-7410
NPI assigned
Apr 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Anita Reiner
Title
Bookkeeping Insurance
Phone
(770) 751-1433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X NU Primary

Addresses

Primary practice location

1265 Upper Hembree Rd
Ste 100
Roswell, GA 30076-1143

Mailing address

1265 Upper Hembree Rd
Ste 100
Roswell, GA 30076-1143
Phone (770) 751-1433

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740245950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 UPPER HEMBREE RD",
            "address_2": "STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761143",
            "telephone_number": "770-751-1433",
            "fax_number": "770-751-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UPPER HEMBREE RD",
            "address_2": "STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761143",
            "telephone_number": "770-751-1433",
            "fax_number": "770-751-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REINER",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "BOOKKEEPING INSURANCE",
        "authorized_official_telephone_number": "770-751-1433",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.