NPIMap

Organization Active NPI

West Georgia Gastroenterology Associates,PC

  • Specialist
  • Carrollton, GA
National Provider Identifier
1962594168
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WEST GEORGIA GASTROENTEROLOGY ASSOCIATES,PC
Practice address
157 Clinic Ave
Suite 201
Carrollton, GA 30117-4454
Phone
(770) 214-2800
Fax
(770) 834-3321
NPI assigned
Sep 28, 2006
Last updated
Feb 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
John Arledge, M.D.NPI 1639249675
Title
Medical Director
Phone
(770) 214-2800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

157 Clinic Ave
Suite 201
Carrollton, GA 30117-4454

Mailing address

157 Clinic Ave Ste 201
Carrollton, GA 30117-4454
Phone (770) 214-2800

Other identifiers 1

IdentifierTypeStateIssuer
CG0644OtherGARAIL ROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000392 GA Part B Supplier - Clinic/Group Practice 5890783104 Receives reassigned benefits from 16 practitioners
Practice locations: Bremen, GA; Carrollton, GA; Newnan, GA; Villa Rica, GA; Wedowee, AL; Woodland, AL

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
11D0879501West Georgia Gastroenterology Assoc PC157 Clinic Avenue, Suite 201, Carrollton, GA 30117Certificate of waiverNov 18, 2027

National Provider Directory

National Provider Directory

Locations

76 County Road 64
Ste 3
Woodland, AL 36280
Phone (256) 449-2001

1755 Highway 34 E
Ste 3400
Newnan, GA 30265
Phone (770) 214-2800

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1962594168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 CLINIC AVE STE 201",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174454",
            "telephone_number": "770-214-2800",
            "fax_number": "770-214-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 CLINIC AVE",
            "address_2": "SUITE 201",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174454",
            "telephone_number": "770-214-2800",
            "fax_number": "770-834-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA GASTROENTEROLOGY ASSOCIATES,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "ARLEDGE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-214-2800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CG0644",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 2, 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.