NPIMap

Organization Active NPI

Northside Bariatric Surgery Center

  • Surgery Physician
  • Atlanta, GA
National Provider Identifier
1891836342
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
37604 Issued in GA
Legal business name
NORTHSIDE BARIATRIC SURGERY CENTER
Practice address
960 Johnson Ferry Rd NE
Suite 228
Atlanta, GA 30342-1631
Phone
(404) 252-2220
Fax
(404) 252-4530
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Tifany Bostwick
Title
Office Administrator
Phone
(404) 252-2220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 37604 GA Primary

Addresses

Primary practice location

960 Johnson Ferry Rd NE
Suite 228
Atlanta, GA 30342-1631

Mailing address

960 Johnson Ferry Rd NE
Suite 228
Atlanta, GA 30342-1631
Phone (404) 252-2220

National Provider Directory

National Provider Directory

Locations

960 Johnson Ferry Rd
Ste 228
Sandy Springs, GA 30342
Phone (404) 252-2220

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1891836342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD NE",
            "address_2": "SUITE 228",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421631",
            "telephone_number": "404-252-2220",
            "fax_number": "404-252-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD NE",
            "address_2": "SUITE 228",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421631",
            "telephone_number": "404-252-2220",
            "fax_number": "404-252-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE BARIATRIC SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "BOSTWICK",
        "authorized_official_first_name": "TIFANY",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "404-252-2220"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "37604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.