Georgia Physicians of Atlanta

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

056706 Issued in GA

Legal business name

GEORGIA PHYSICIANS OF ATLANTA

Practice address

35 Patterson Rd
Suite 466384
Lawrenceville, GA 30044-4717

Phone

(770) 689-9565

Fax

(888) 267-9812

NPI assigned

Aug 31, 2016

Organization subpart

No

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

Authorized official

Name

Lakesha Cooper

Title

Secretary

Phone

(770) 689-9565

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1891241758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 PATTERSON RD",
            "address_2": "SUITE 466384",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444717",
            "telephone_number": "770-689-9565",
            "fax_number": "888-267-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 PATTERSON RD",
            "address_2": "SUITE 466384",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444717",
            "telephone_number": "770-689-9565",
            "fax_number": "888-267-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA PHYSICIANS OF ATLANTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "LAKESHA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "770-689-9565"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "056706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Georgia Sleep Centers
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• Surgical Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.