NPIMap

Organization Active NPI

RSPS Fayetteville ASC LLC

Doing business as RSPS Fayetteville ASC

  • Ambulatory Surgical Clinic/Center
  • Fayetteville, GA
National Provider Identifier
1750905618
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
RSPS FAYETTEVILLE ASC LLC
Doing business as
RSPS Fayetteville ASC
Practice address
874 Lanier Ave W Ste 260
Fayetteville, GA 30214-7669
Phone
(404) 618-0995
Fax
(404) 618-0995
NPI assigned
Jun 5, 2020
Last updated
Dec 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Authorized official

Name
Dr. Zwade Marshall, MDNPI 1750671400
Title
Owner
Phone
(404) 618-0995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU

Addresses

Primary practice location

874 Lanier Ave W Ste 260
Fayetteville, GA 30214-7669

Mailing address

874 Lanier Ave W Ste 260
Fayetteville, GA 30214-7669
Phone (404) 618-0995

Other names 1

  • RSPS Fayetteville ASC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address zmarshall@regenerativespines.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220404002735 GA Part B Supplier - Ambulatory Surgical Center 8628484201 Receives reassigned benefits from 3 practitioners
Practice locations: Fayetteville, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
RSPS Fayetteville ASC LLC Dba RSPS Fayetteville ASCCCN 11C0001547
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2187806RSPS Fayetteville ASC874 West Lanier Avenue Suite 260, Fayetteville, GA 30214Certificate of waiverJul 7, 2028

National Provider Directory

National Provider Directory

Locations

874 Lanier Ave W
Ste 270
Fayetteville, GA 30214
Phone (770) 461-1335

Practitioners & affiliated clinicians

Practitioners 10

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": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1750905618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 LANIER AVE W STE 260",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147669",
            "telephone_number": "404-618-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 LANIER AVE W STE 260",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147669",
            "telephone_number": "404-618-0995",
            "fax_number": "404-618-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RSPS FAYETTEVILLE ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-05",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "ZWADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-618-0995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zmarshall@regenerativespines.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "874 Lanier Ave W Ste 260",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302147669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "RSPS Fayetteville ASC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.