Wguasc, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

WGUASC, LLC

Practice address

150 Clinic Ave Ste 203
Carrollton, GA 30117-4402

Phone

(707) 834-6988

Fax

(770) 834-1090

NPI assigned

May 9, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Clint Hoffman

Title

Sr VP

Phone

(770) 838-8302

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Wguasc LLCCCN 11C0001514

Medicare certification status

ActiveFrom 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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Tanner Medical Center, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Carrollton, GA
  • NPI 1104850965

  Member Of

  NPD member

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1922597517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GREENWAY BLVD FL 2",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174338",
            "telephone_number": "770-838-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CLINIC AVE STE 203",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174402",
            "telephone_number": "707-834-6988",
            "fax_number": "770-834-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WGUASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "CLINT",
        "authorized_official_title_or_position": "SR VP",
        "authorized_official_telephone_number": "770-838-8302",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West Georgia Surgery Center, LLC
• West Georgia Urology Associates PC
• Lisa M West, RN
• WGG Anesthesia, LLC
• Wguas, LLC
• Stacie Whalen
• Richard Whitaker, M.D.
• White Coat Sciences LLC
• James B White, MD
• Randel Everette Whitehead Jr., D.C.

• Ambulatory Surgical Clinic/Center in Carrollton, GA
• Providers in Carrollton, 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 Feb 29, 2024; 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.