NPIMap

Organization Active NPI

Atlanta Surgery Group Specialists LLC

  • Surgical Technologist
  • Norcross, GA
National Provider Identifier
1962696203
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
Legal business name
ATLANTA SURGERY GROUP SPECIALISTS LLC
Practice address
4088 Jones Bridge Cir
Norcross, GA 30092-1214
Phone
(404) 668-6112
NPI assigned
Aug 29, 2007
Last updated
Aug 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

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

Authorized official

Name
Mr. Mario Luque, CSA-FANPI 1316139694
Title
President
Phone
(404) 668-6112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X NU Primary

Addresses

Primary practice location

4088 Jones Bridge Cir
Norcross, GA 30092-1214

Mailing address

PO Box 11512
Atlanta, GA 30355-1512
Phone (404) 668-6112

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345420800000",
    "number": "1962696203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11512",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303551512",
            "telephone_number": "404-668-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4088 JONES BRIDGE CIR",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300921214",
            "telephone_number": "404-668-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA SURGERY GROUP SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2012-08-20",
        "status": "A",
        "authorized_official_last_name": "LUQUE",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-668-6112",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CSA-FA"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.