NPIMap

Organization Active NPI

Dalton Surgical Group PC

  • Surgery Physician
  • Dalton, GA
National Provider Identifier
1811005143
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
DALTON SURGICAL GROUP PC
Practice address
1504 Broadrick Dr
Dalton, GA 30720
Phone
(706) 278-6403
Fax
(706) 278-0087
NPI assigned
Aug 28, 2006
Last updated
Jun 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Authorized official

Name
Wanda Holt
Title
Office Manager
Phone
(706) 278-6403

Specialties & licenses 1

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

Addresses

Primary practice location

1504 Broadrick Dr
Dalton, GA 30720

Mailing address

PO Box 1969
1504 Broadrick Dr
Dalton, GA 30722-1969
Phone (706) 278-6403

National Provider Directory

National Provider Directory

Locations

1504 Broadrick Dr
Dalton, GA 30720
Phone (706) 278-6403

102 Gross Crescent Cir
Ste 205
Ft Oglethorpe, GA 30742
Phone (706) 858-1195

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8594/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1811005143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1969",
            "address_2": "1504 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307221969",
            "telephone_number": "706-278-6403",
            "fax_number": "706-278-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-278-6403",
            "fax_number": "706-278-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALTON SURGICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-278-6403"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.