NPIMap

Gastrointestinal Specialist of Georgia

Organization Active NPI Gastroenterology Physician · Marietta, GA

NPI 1801975339 · NPPES record last updated Dec 7, 2016

Key facts

NPI
1801975339
Entity type
Organization (NPI type 2)
Primary specialty
Gastroenterology Physician 207RG0100X
Legal business name
GASTROINTESTINAL SPECIALIST OF GEORGIA
Practice address
711 Canton Rd NE
Suite 300
Marietta, GA 30060-8948
Phone
(678) 741-5000
Fax
(770) 944-4522
NPI assigned
Nov 3, 2006
Organization subpart
No

Authorized official

Name
Dr. Arif Aziz, MD
Title
Managing Partner
Phone
(678) 741-2317

Practitioners 63

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

View all 63

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040206000897 GA Part B Supplier - Clinic/Group Practice 9335032820 Receives reassigned benefits from 54 practitioners
Practice locations: Woodstock, GA; Roswell, GA; Marietta, GA; Lithia Springs, GA; Hiram, GA; Douglasville, GA; Canton, GA; Acworth, GA

National Provider Directory

Locations

4900 Ivey Rd NW
Bldg 1000
Acworth, GA 30101
Phone (770) 429-0031

4900 Ivey Rd NW
Ste 150
Acworth, GA 30101

4550 Cobb Parkway North NW
Ste 214
Acworth, GA 30101

13 Reinhardt College Pkwy
#20
Canton, GA 30114

6001 Professional Pkwy
Ste 2060
Douglasville, GA 30134
Phone (770) 739-9555

6002 Professional Pkwy
Douglasville, GA 30134
Phone (770) 949-8552

880 Crestmark Dr
Lithia Springs, GA 30122

1121 Johnson Ferry Rd
Bldg 2
Marietta, GA 30068

61 Whitcher St NE
#3100
Marietta, GA 30060

3834 Austell Rd SW
Ste A
Marietta, GA 30008

2550 Windy Hill Rd SE
Marietta, GA 30067
Phone (678) 303-3200

3200 Highlands Pkwy SE
Ste 430
Smyrna, GA 30082
Phone (770) 739-9555

118 Mill St
Woodstock, GA 30188

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207RG0100X GA Yes

Addresses

Primary practice location

711 Canton Rd NE
Suite 300
Marietta, GA 30060-8948

Mailing address

711 Canton Rd NE
Suite 300
Marietta, GA 30060-8948
Phone (678) 741-5000

Other identifiers

IdentifierTypeStateIssuer
300031375AMedicaidGA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 7, 2016.

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1801975339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 CANTON RD NE",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608948",
            "telephone_number": "678-741-5000",
            "fax_number": "770-944-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 CANTON RD NE",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608948",
            "telephone_number": "678-741-5000",
            "fax_number": "770-944-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROINTESTINAL SPECIALIST OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "AZIZ",
        "authorized_official_first_name": "ARIF",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "678-741-2317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300031375A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

All providers in Marietta, GA · Gastroenterology Physician in Georgia

Sources for this page

Verify at the official NPI Registry.