NPIMap

Organization Active NPI

Surgery South PC

  • Surgery Physician
  • Stockbridge, GA
National Provider Identifier
1861527616
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SURGERY SOUTH PC
Practice address
1040 Eagles Landing Pkwy
Suite 100
Stockbridge, GA 30281-9072
Phone
(770) 474-7287
Fax
(770) 389-3713
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Brian S Myers, MDNPI 1083602643
Title
President Ceo Surgery South PC
Phone
(770) 474-7287

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 1

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

Addresses

Primary practice location

1040 Eagles Landing Pkwy
Suite 100
Stockbridge, GA 30281-9072

Mailing address

1040 Eagles Landing Pkwy
Suite 100
Stockbridge, GA 30281-9072
Phone (770) 474-7287

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040527000729 GA Part B Supplier - Clinic/Group Practice 5991786725 Receives reassigned benefits from 6 practitioners
Practice locations: Stockbridge, GA

National Provider Directory

National Provider Directory

Locations

1040 Eagles Landing Pkwy
Ste 100
Stockbridge, GA 30281
Phone (770) 474-7287

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1861527616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 EAGLES LANDING PKWY",
            "address_2": "SUITE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819072",
            "telephone_number": "770-474-7287",
            "fax_number": "770-389-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 EAGLES LANDING PKWY",
            "address_2": "SUITE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819072",
            "telephone_number": "770-474-7287",
            "fax_number": "770-389-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY SOUTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT CEO SURGERY SOUTH PC",
        "authorized_official_telephone_number": "770-474-7287",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.