Georgia Urology Ambulatory Surgical Center LLC

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

Organization subpart

Yes

Parent organization

GEORGIA UROLOGY, PAAs reported in NPPES

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

Authorized official

Name

Dr. Mark A Haber, MD

Title

Managing Partner

Phone

(678) 284-4049

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Georgia Urology

Locations

Practitioners 1

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

• Carl C Capelouto, M.D.

  • Urology Physician
  • Canton, GA
  • NPI 1538277710
  NPD (past)

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "11D1025964",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgia Professional Medical Services LLC
• Georgia Regional Hospital
• Georgia Regional Hospital Pharmacy
• Georgia Spine & Neurosurgery Center LLC
• Georgia Spine & Neurosurgery Center, LLC
• Georgia Urology PA
• Georgia Urology PA
• Georgia Urology PA
• Georgia Urology, PA
• Robert Gerardi, PH.D.

• Ambulatory Surgical Clinic/Center in Decatur, GA
• Providers in Decatur, 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 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.