NPIMap

Organization Active NPI

Cpmsc Canton, LLC

  • Ambulatory Surgical Clinic/Center
  • Canton, GA
National Provider Identifier
1952737207
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CPMSC CANTON, LLC
Practice address
134 Riverstone Terrace
Suite 102
Canton, GA 30114
Phone
(770) 929-9033
Fax
(770) 929-9092
NPI assigned
Sep 18, 2013
Last updated
Feb 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Authorized official

Name
Victoria Beck, CFO
Title
Chief Financial Officer
Phone
(404) 920-4950

Specialties & licenses 1

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

Addresses

Primary practice location

134 Riverstone Terrace
Suite 102
Canton, GA 30114

Mailing address

PO Box 11407 Dept 2570
Birmingham, AL 35246-2570
Phone (770) 929-9033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

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…
O20140527001057 GA Part B Supplier - Ambulatory Surgical Center 7012130776 Receives reassigned benefits from 8 practitioners
Practice locations: Canton, 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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Cpmsc Canton LLCCCN 11C0001425
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
11D2186447Cpmsc Canton, LLC134 Riverstone Terrace, Suite 102, Canton, GA 30114Certificate of waiverJun 16, 2028

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1952737207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DEPT 2570",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352462570",
            "telephone_number": "770-929-9033",
            "fax_number": "770-929-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 RIVERSTONE TERRACE",
            "address_2": "SUITE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "30114",
            "telephone_number": "770-929-9033",
            "fax_number": "770-929-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPMSC CANTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-18",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "404-920-4950",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.