Cobblestone Surgery Center, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

LNRASC2014004 Issued in GA

Legal business name

COBBLESTONE SURGERY CENTER, INC.

Practice address

3450 Acworth Due West Rd NW
BLDG. 200, Suite 100
Kennesaw, GA 30144-1078

Phone

(770) 794-6643

Fax

(770) 794-6683

NPI assigned

Jul 16, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Marcus Crawford, MD

Title

President

Phone

(770) 794-6643

Specialties & licenses 1

Addresses

Listed as

Cobblestone Surgery CenterCCN 11C0001493

Medicare certification status

Terminated Voluntary: merger or closure, Dec 19, 2024From the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1902213432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 ACWORTH DUE WEST RD NW",
            "address_2": "BLDG. 200, SUITE 100",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441078",
            "telephone_number": "770-794-6643",
            "fax_number": "770-794-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 ACWORTH DUE WEST RD NW",
            "address_2": "BLDG. 200, SUITE 100",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441078",
            "telephone_number": "770-794-6643",
            "fax_number": "770-794-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBBLESTONE SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-794-6643",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "LNRASC2014004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cobb Medical Supply, Inc
• Cobb Pharmacy, Inc
• Cobb Podiatry, P.C.
• Cobb Regenerative & Joint Clinic LLC
• Cobblestone Anesthesia Incorporated
• Angel M Cobiella, MD MBA
• Cody Comfort Care LLC
• Caitlyn Cofer, PTA
• Cana Coleman
• Cheryl Nancy Coletta, PSY.D.

• Ambulatory Surgical Clinic/Center in Kennesaw, GA
• Providers in Kennesaw, 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 Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.