Georgia Urology PA

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

GEORGIA UROLOGY PA

Practice address

6000 Hillandale Dr Ste 110
Lithonia, GA 30058-4858

Phone

(770) 981-2090

Fax

(770) 981-7411

NPI assigned

Apr 15, 2007

Organization subpart

Yes

Parent organization

GEORGIA UROLOGY PAAs reported in NPPES

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

Authorized official

Name

Dan Fellner

Title

Ceo

Phone

(678) 205-8360

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Georgia Urology

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

{
    "created_epoch": "1176595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1962627158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 HILLANDALE DR STE 110",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584858",
            "telephone_number": "770-981-2090",
            "fax_number": "770-981-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA UROLOGY PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA UROLOGY PA",
        "enumeration_date": "2007-04-15",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "FELLNER",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-205-8360"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "11D0995868",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgia Pain and Wellness Center
• Georgia Pharmacy LLC
• Georgia Residential and Community Healthcare, Inc
• Georgia Urology PA
• Georgia Urology PA
• Derick Jermaine Gerideau
• Annie Elizabeth Gibson-Boyd, R.D.,L.D.
• Vanessa Gilbert
• Billie Renee Gill-Chestnut, RPT
• Kaleb Aiden Gilmer, LPC

• Urology Physician in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.