Organization Active NPI

Hudes Endoscopy Center LLC

  • Endoscopy Clinic/Center
  • Suwanee, GA
National Provider Identifier
1922125285
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
License
058-318 Issued in GA
Legal business name
HUDES ENDOSCOPY CENTER LLC
Doing business as
Johns Creek Endoscopy Center
Practice address
4275 Johns Creek Pkwy
Suite a
Suwanee, GA 30024-6038
Phone
(678) 475-1606
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Jana Baker
Title
Administrator
Phone
(404) 888-7575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X 058-318 GA Primary

Addresses

Primary practice location

4275 Johns Creek Pkwy
Suite a
Suwanee, GA 30024-6038

Mailing address

4275 Johns Creek Pkwy
Suite a
Suwanee, GA 30024-6038
Phone (678) 475-1606

Other names 1

  • Johns Creek Endoscopy Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051116000220 GA Part B Supplier - Ambulatory Surgical Center 1658390943 Practice locations: Suwanee, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Hudes Endoscopy Center LLCCCN 11C0001269
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1037753Johns Creek Endoscopy4275 Johns Creek Pkwy, Suite a, Suwanee, GA 30024Certificate of waiverMar 2, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

4275 Johns Creek Pkwy
Ste A
Suwanee, GA 30024
Phone (678) 475-1606

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1922125285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4275 JOHNS CREEK PKWY",
            "address_2": "SUITE A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246038",
            "telephone_number": "678-475-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 JOHNS CREEK PKWY",
            "address_2": "SUITE A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246038",
            "telephone_number": "678-475-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDES ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "404-888-7575"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "GA",
            "license": "058-318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johns Creek Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.