NPIMap

Organization Active NPI

West Georgia Center for Plastic Surgery, LLC

  • Ambulatory Surgical Clinic/Center
  • Carrollton, GA
National Provider Identifier
1952391591
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
030330 Issued in GA
Legal business name
WEST GEORGIA CENTER FOR PLASTIC SURGERY, LLC
Practice address
150 Henry Burson Ave
Suite 200
Carrollton, GA 30117-4465
Phone
(770) 834-6302
Fax
(770) 834-7660
NPI assigned
Oct 25, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Authorized official

Name
Dr. Stephen Housman Kahler, M.D.
Title
Principal Officer
Phone
(770) 834-6302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 030330 GA Primary

Addresses

Primary practice location

150 Henry Burson Ave
Suite 200
Carrollton, GA 30117-4465

Mailing address

150 Henry Burson Ave
Suite 200
Carrollton, GA 30117-4465
Phone (770) 834-6302

Other identifiers 2

IdentifierTypeStateIssuer
R566OtherGACOMMERCIAL INS./AMERIHEAL
0007430251OtherGAAETNA

Other names 1

  • Plastic Surgery Center of West Georgia, LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1952391591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HENRY BURSON AVE",
            "address_2": "SUITE 200",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174465",
            "telephone_number": "770-834-6302",
            "fax_number": "770-834-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 HENRY BURSON AVE",
            "address_2": "SUITE 200",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174465",
            "telephone_number": "770-834-6302",
            "fax_number": "770-834-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA CENTER FOR PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "KAHLER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "HOUSMAN",
        "authorized_official_title_or_position": "PRINCIPAL OFFICER",
        "authorized_official_telephone_number": "770-834-6302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "030330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INS./AMERIHEAL",
            "identifier": "R566",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007430251",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plastic Surgery Center of West Georgia, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.