NPIMap

Organization Active NPI

Northside Surgical Associate

  • Surgery Physician
  • Jasper, GA
National Provider Identifier
1740355338
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTHSIDE SURGICAL ASSOCIATE
Practice address
80 Interstate South Dr
Ste B
Jasper, GA 30143-6226
Phone
(706) 692-9081
Fax
(706) 692-0155
NPI assigned
Nov 21, 2006
Last updated
May 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Rosa L Langella, M.D.NPI 1386606283
Title
Co Owner
Phone
(706) 692-9081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

80 Interstate South Dr
Ste B
Jasper, GA 30143-6226

Mailing address

80 Interstate South Dr
Ste B
Jasper, GA 30143-6226
Phone (706) 692-9081

National Provider Directory

National Provider Directory

Locations

125 Oakside Ct
Ste 101
Canton, GA 30114
Phone (770) 479-3424

80 Fairview Rd
Ste B
Jasper, GA 30143
Phone (706) 253-2230

80 Interstate South Dr
#B
Jasper, GA 30143
Phone (678) 454-3306

Practitioners & affiliated clinicians

Practitioners 6

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": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1740355338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 INTERSTATE SOUTH DR",
            "address_2": "STE B",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301436226",
            "telephone_number": "706-692-9081",
            "fax_number": "706-692-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 INTERSTATE SOUTH DR",
            "address_2": "STE B",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301436226",
            "telephone_number": "706-692-9081",
            "fax_number": "706-692-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE SURGICAL ASSOCIATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "LANGELLA",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "706-692-9081",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.