Medici Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MEDICI SURGICAL CENTER, LLC

Practice address

792 Church St NE Ste 101
Marietta, GA 30060-7291

Phone

(844) 328-4624

NPI assigned

Nov 8, 2017

Last updated

Dec 11, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sonny Dosanjh, MDNPI 1952596850

Title

Cmo

Phone

(844) 328-4624

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Medici Surgical Center LLCCCN 11C0001498

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

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8922/brand/1/csg/1/fhir/r4

Practitioners 3

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.

• Sonny Sandeep Singh Dosanjh, MD

  • Physical Medicine & Rehabilitation Physician
  • Kennesaw, GA
  • NPI 1952596850
  NPD Authorized official
• Meetali Crowe, NP

  • Family Nurse Practitioner
  • Conyers, GA
  • NPI 1043932973
  NPD (past)
• Paul King White, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Stockbridge, GA
  • NPI 1225355993
  NPD (past)

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1952814352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 GEORGE BUSBEE PKWY NW STE 50",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446910",
            "telephone_number": "844-328-4624",
            "fax_number": "770-882-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 CHURCH ST NE STE 101",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607291",
            "telephone_number": "844-328-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICI SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "DOSANJH",
        "authorized_official_first_name": "SONNY",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "844-328-4624",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med Pro USA, LLC
• Med USA
• Medex RX LLC (Medex Pharmacy)
• Medic One LLC
• Medical Practice of James L. Fisher
• Medico Diagnostics
• Carolina Medina, RN
• Leah A Medlin (Beltz), HEARING AID DISPENSE
• Medlin Treatment Center Inc
• Julie Christine Medlin, PH.D.

• Ambulatory Surgical Clinic/Center in Marietta, GA
• Providers in Marietta, 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 Dec 11, 2018; 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.