NPIMap

Organization Active NPI

Georgia Urology Ambulatory Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • Decatur, GA
National Provider Identifier
1891716049
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GEORGIA UROLOGY AMBULATORY SURGICAL CENTER LLC
Practice address
2685 Milscott Dr
Decatur, GA 30033-5906
Phone
(404) 292-3727
Fax
(404) 294-9674
NPI assigned
Jul 22, 2006
Last updated
Jan 20, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA UROLOGY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Authorized official

Name
Dr. Mark A Haber, MDNPI 1710089404
Title
Managing Partner
Phone
(678) 284-4049

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X GA Primary

Addresses

Primary practice location

2685 Milscott Dr
Decatur, GA 30033-5906

Mailing address

1930 Brannan Rd
McDonough, GA 30253-4310
Phone (678) 284-4040

National Provider Directory

National Provider Directory
Part of
Georgia Urology PA

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": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1891716049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 MILSCOTT DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335906",
            "telephone_number": "404-292-3727",
            "fax_number": "404-294-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA UROLOGY AMBULATORY SURGICAL CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA UROLOGY, PA",
        "enumeration_date": "2006-07-22",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "HABER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "678-284-4049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.