Northlake Endoscopy Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

044047 Issued in GA

Legal business name

NORTHLAKE ENDOSCOPY CENTER

Practice address

1459 Montreal Rd
Su 204
Tucker, GA 30084-6900

Phone

(770) 939-4721

Fax

(770) 939-1187

NPI assigned

Aug 4, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Ralph Robert Beton, MDNPI 1932100609

Title

President

Phone

(770) 939-4721

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Ralph Robert Beton, MD

  • Specialist
  • Tucker, GA
  • NPI 1932100609
  NPD (past) Authorized official
• Joseph Gordon Edelson, MD

  • Gastroenterology Physician
  • Petoskey, MI
  • NPI 1598766255
  NPD (past)

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1871594499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 MONTREAL RD",
            "address_2": "SU 204",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846900",
            "telephone_number": "770-939-4721",
            "fax_number": "770-939-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 MONTREAL RD",
            "address_2": "SU 204",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846900",
            "telephone_number": "770-939-4721",
            "fax_number": "770-939-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAKE ENDOSCOPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-04",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "BETON",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-939-4721",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "044047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000468652A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisa Norall
• North Fulton Anesthesia Associates
• North Star of Georgia Counseling
• Christopher Pollard North, D.M.D.
• Northeast Atlanta Associates in Gastroenterology
• Northlake Internal Medicine
• Northlake Medical Center LLC
• Northlake Medical Center, LLC
• Northlake Medical Center, LLC
• Northlake Medical Center, LLC

• Ambulatory Surgical Clinic/Center in Tucker, GA
• Providers in Tucker, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.