Fayette Surgical Associates

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

FAYETTE SURGICAL ASSOCIATES

Practice address

1265 Highway 54 W
Suite 500B
Fayetteville, GA 30214-4548

Phone

(770) 719-5660

Fax

(678) 817-4339

NPI assigned

Nov 9, 2007

Last updated

Dec 13, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diana Lowery

Title

Office Manager

Phone

(770) 719-5660

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• John Sams Goza, MD

  • Surgery Physician
  • Overland Park, KS
  • NPI 1760481105
  NPD (past)

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1871773549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 HIGHWAY 54 W",
            "address_2": "SUITE 500B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144548",
            "telephone_number": "770-719-5660",
            "fax_number": "678-817-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 HIGHWAY 54 W",
            "address_2": "SUITE 500B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144548",
            "telephone_number": "770-719-5660",
            "fax_number": "678-817-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTE SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "LOWERY",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-719-5660"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA6744",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fayette Eye Center PC
• Fayette Hearing Clinic Inc (Fayette Hearing Clinic)
• Fayette Medical Clinic Optical Shop
• Fayette Pharmacy LLC
• Fayette Plasticsurgery Center LLC
• Fayette Surgical Associates, LLC
• Fayetteville Center for Nursing & Healing LLC
• Fayetteville Dental Group
• Fayetteville Ga Opco LLC (Condor Health Lafayette)
• Fayetteville Orthodontics LLC

• Specialist in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.