NPIMap

Organization Active NPI

Ispm ASC at Camp Creek LLC

  • Ambulatory Surgical Clinic/Center
  • Atlanta, GA
National Provider Identifier
1942548870
Registry record updated Feb 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ISPM ASC AT CAMP CREEK LLC
Practice address
3885 Princeton Lakes Way SW
Ste 400
Atlanta, GA 30331-5589
Phone
(404) 920-4950
Fax
(404) 920-4959
NPI assigned
Jan 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2020

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

Authorized official

Name
Dr. Robin James Fowler, M.D.
Title
Owner/Medical Director
Phone
(404) 920-4950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3885 Princeton Lakes Way SW
Ste 400
Atlanta, GA 30331-5589

Mailing address

PO Box 11407 Dept 2330
Birmingham, AL 35246-0001
Phone (404) 920-4950

Other names 1

  • Alliance Surgery Center at Camp Creek Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110120001157 GA Part B Supplier - Clinic/Group Practice 6406035583 Receives reassigned benefits from 110 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Roswell, GA; Marietta, GA; Lawrenceville, GA; Douglasville, GA; Dallas, GA; Covington, GA; Conyers, GA; Carrollton, GA…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Alliance Surgery Center at Augusta7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582934400000",
    "number": "1942548870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DEPT 2330",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460001",
            "telephone_number": "404-920-4950",
            "fax_number": "404-920-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 PRINCETON LAKES WAY SW",
            "address_2": "STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315589",
            "telephone_number": "404-920-4950",
            "fax_number": "404-920-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISPM ASC AT CAMP CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "404-920-4950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alliance Surgery Center at Camp Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.