Sumner Neurology Associates, PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

16896 Issued in TN

Legal business name

SUMNER NEUROLOGY ASSOCIATES, PLLC

Practice address

1000 Johnson Ferry Rd BLDG F
Ste.120
Marietta, GA 30068-2114

Phone

(678) 402-1053

Fax

(678) 402-5619

NPI assigned

Mar 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jawaid Ahsan, M.D.NPI 1578618815

Title

Owner

Phone

(678) 402-1053

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• Jawaid Ahsan, MD

  • Neurology Physician
  • Rome, GA
  • NPI 1578618815
  Medicare reassignment Authorized official
• Barbara Ellen Tucker, RD, LD, MED.

  • Registered Dietitian
  • Marietta, GA
  • NPI 1922052620
  NPD (past)
• Yolanda Dorsey, NP

  • Family Nurse Practitioner
  • Gallatin, TN
  • NPI 1316162134
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1801926381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 680010",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300680001",
            "telephone_number": "678-402-1053",
            "fax_number": "678-402-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD BLDG F",
            "address_2": "STE.120",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682114",
            "telephone_number": "678-402-1053",
            "fax_number": "678-402-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMNER NEUROLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "AHSAN",
        "authorized_official_first_name": "JAWAID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-402-1053",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "TN",
            "license": "16896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "871643718A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "871643718A",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FA1875624",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Marietta, GA
• Providers in Marietta, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.