Northwest ENT Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NORTHWEST ENT SURGERY CENTER, LLC

Practice address

960 Woodstock Pkwy
Suite 101
Woodstock, GA 30188-4866

Phone

(678) 483-8833

Fax

(678) 483-8809

NPI assigned

Mar 1, 2012

Organization subpart

No

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

Authorized official

Name

Carlos M Egea

Title

Administrator

Phone

(770) 427-0368

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Northwest ENT Surgery Center LLCCCN 11C0001386

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

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shatul L. Parikh, M.D.

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1447434915
  NPD
• Elizabeth Ashlie Darr, M.D.

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1710145883
  NPD (past)
• Avani Patel Ingley, MD

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1134305030
  NPD (past)
• Ryan Matthew Kauffman, M.D.

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1881873271
  NPD (past)
• Drew Matthew Locandro, M.D.

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1790786911
  NPD (past)
• Hannan Asim Qureshi, M.D.

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1942691910
  NPD (past)
• Bryan J Stringham, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Marietta, GA
  • NPI 1801052071
  NPD (past)

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1982978466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 WOODSTOCK PKWY",
            "address_2": "SUITE 101",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884866",
            "telephone_number": "678-483-8833",
            "fax_number": "678-483-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 WOODSTOCK PKWY",
            "address_2": "SUITE 101",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884866",
            "telephone_number": "678-483-8833",
            "fax_number": "678-483-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ENT SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "EGEA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-427-0368"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA STATE LICENSE",
            "identifier": "028-461",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Georgia Spinal Associates LLC
• North Georgia Surgical Assistants, LLC
• Northern Professional Center Inc
• Northwest Diagnostic Imaging, Inc
• Northwest Endodontic Specialists, P.C.
• Northwest Georgia Oncology Centers
• Northwest Georgia Plastic Surgery LLC
• Nuch of Georgia LLC
• Lucia Nunez
• Nuwave Medical Supply, LLC

• Ambulatory Surgical Clinic/Center in Woodstock, GA
• Providers in Woodstock, 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 Jan 18, 2013; 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.