Dekalb Surgical Associates, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

DEKALB SURGICAL ASSOCIATES, P.C.

Practice address

2665 N Decatur Rd
Suite 730
Decatur, GA 30033-6149

Phone

(404) 508-4320

Fax

(404) 508-4112

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

John Sargent Kennedy, M.D.NPI 1275526386

Title

President

Phone

(404) 508-4320

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Sargent Kennedy, M.D.

  • Surgery Physician
  • Decatur, GA
  • NPI 1275526386

  Specialist

  Medicare reassignment NPD Authorized official
• Michael Scott Champney, M.D.

  • Surgery Physician
  • Decatur, GA
  • NPI 1386637403

  Specialist

  Medicare reassignment NPD
• David R Fern, M.D.

  • Specialist
  • Decatur, GA
  • NPI 1265425581
  Medicare reassignment NPD
• Ashleigh Guinn Ross, D.O.

  • Surgery Physician
  • Decatur, GA
  • NPI 1215382809

  Specialist

  Medicare reassignment NPD
• Andrei Carol Stieber, M.D.

  • Surgery Physician
  • Decatur, GA
  • NPI 1235194101
  Medicare reassignment NPD
• Michael James Cornwell, M.D.

  • Specialist
  • Decatur, GA
  • NPI 1396738613
  NPD (past)
• Alexander D. Park, M.D.

  • Surgery Physician
  • Suwanee, GA
  • NPI 1710946314
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1770532590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 N DECATUR RD",
            "address_2": "SUITE 730",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336149",
            "telephone_number": "404-508-4320",
            "fax_number": "404-508-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 N DECATUR RD",
            "address_2": "SUITE 730",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336149",
            "telephone_number": "404-508-4320",
            "fax_number": "404-508-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SARGENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-508-4320",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dekalb Orthopedic Clinic PA
• Dekalb Pain Center
• Dekalb Pathology PC
• Dekalb Pediatric Center
• Dekalb Rape Crisis Center Inc
• Dekalb Women's Specialists
• Dekalb Women's Specialists 2 LLC
• Jozsalina Del Val
• Rosetta Yvette Delancy, LCSW
• Alexandria Deland, PA-C

• Specialist in Decatur, GA
• Providers in Decatur, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.