Organization Active NPI

Gastrocare Physicians of Georgia LLC

  • Gastroenterology Physician
  • Madison, GA
National Provider Identifier
1871365478
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROCARE PHYSICIANS OF GEORGIA LLC
Practice address
1680A Eatonton Rd
Madison, GA 30650-4628
Phone
(404) 282-5600
Fax
(404) 282-5599
NPI assigned
Oct 26, 2023
Last updated
Jan 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Dr. David Neal Socoloff, MDNPI 1295824175
Title
Owner
Phone
(404) 386-7480

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
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

1680A Eatonton Rd
Madison, GA 30650-4628

Mailing address

5400 Glenridge Dr Unit 420337
Atlanta, GA 30342-7513
Phone (678) 447-0678

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240119001473 GA Part B Supplier - Clinic/Group Practice 6800248436 Receives reassigned benefits from 2 practitioners
Practice locations: Madison, GA

National Provider Directory

National Provider Directory

Locations

5400 Glenridge Dr
Unit 420337
Sandy Springs, GA 30342
Phone (678) 447-0678

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1871365478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 GLENRIDGE DR UNIT 420337",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303427513",
            "telephone_number": "678-447-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680A EATONTON RD",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306504628",
            "telephone_number": "404-282-5600",
            "fax_number": "404-282-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROCARE PHYSICIANS OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-26",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "SOCOLOFF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-386-7480",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.