Profound Surgical Assistants, LLC

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Legal business name

PROFOUND SURGICAL ASSISTANTS, LLC

Practice address

5401 Sand Bar LN
College Park, GA 30349-3063

Phone

(214) 227-2457

Fax

(214) 764-0880

NPI assigned

Mar 9, 2020

Organization subpart

No

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

Authorized official

Name

Uton Williams, CSANPI 1518467224

Title

Owner

Phone

(770) 940-0185

Specialties & licenses 1

Addresses

Practitioners 1

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

• Uton Williams, CSA

  • Surgical Assistant
  • College Park, GA
  • NPI 1518467224
  NPD Authorized official

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661558400000",
    "number": "1871128975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SAND BAR LN",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493063",
            "telephone_number": "770-940-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 SAND BAR LN",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493063",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFOUND SURGICAL ASSISTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-09",
        "last_updated": "2022-08-27",
        "certification_date": "2022-08-27",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "UTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-940-0185",
        "authorized_official_credential": "CSA"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Assistant in College Park, GA
• Providers in College Park, GA by specialty
• Surgical Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2022; 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.