PREMIER SURGICAL PAVILION OF ATLANTA LLC (NPI# 1104301274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104301274 |
| Entity Type | Organization |
| Organization Name | PREMIER SURGICAL PAVILION OF ATLANTA LLC |
| Practice Address |
1 Baltimore Pl Nw Ste 400 Atlanta GA 30308-2117 |
| Mailing Address |
Po Box 1970 New York NY 10156-1970 |
| Practice Telephone | 2122230716 |
| Mailing Telephone | 2122230716 |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |
| Authorized Official Name | MICHAEL E JONES (OWNER) |
| Authorized Official Telephone | 2122230716 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
1 BALTIMORE PL NW STE 400 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30308-2117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487691580 | Antonio L Rios | Nurse Anesthetist, Certified Registered | 1 Baltimore Pl Nw Ste 400, Atlanta, GA 30308-2117 | 2006-05-31 |
| 1295340305 | Piergiorgio Allegra | Plastic Surgery | 1 Baltimore Pl Nw Ste 400, Atlanta, GA 30308-2117 | 2020-09-15 |
| 1407493026 | Renee Jodian Smith | Nurse Practitioner | 1 Baltimore Pl Nw Ste 400, Atlanta, GA 30308-2117 | 2019-12-02 |
| 1215587670 | Imed Surgical of Atlanta PC | Surgery | 1 Baltimore Pl Nw Ste 400, Atlanta, GA 30308-2117 | 2019-09-18 |
| 1043863889 | Varsha Patel | Nurse Practitioner | 1 Baltimore Pl Nw Ste 400, Atlanta, GA 30308 | 2019-07-22 |
| 1568937084 | Onyinyechi Uloma Eke | Nurse Practitioner | 1 Baltimore Pl Nw Ste 400, Atlanta, GA 30308-2117 | 2018-10-11 |
| 1013213016 | Atlanta Aesthetic and Reconstructive Surgery Center, LLC | Clinic/Center | 1 Baltimore Pl Nw Ste 400, Atlanta, GA 30308-2117 | 2011-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285165 | Grace Mckinnon Cutchin | Speech-Language Pathologist | 550 Peachtree St. Ne, 9th Floor, Suite 4400, Atlanta, GA 30308 | 2020-08-10 |
| 1063033942 | Life University | Chiropractor | 1 Baltimore P1. Nw, Suite 100, Atlanta, GA 30308 | 2020-05-01 |
| 1184254591 | Jordan Cohen | Specialist | 1075 Peachtree Rd, Suite 300, Atlanta, GA 30308 | 2020-01-24 |
| 1104463819 | Gary Sydney Koech IIi | Registered Nurse | Emory Midtown- Davis Fischer Bld 3rd Floor, Rm 3245a, 550 Peachtree Street, N.e., Atlanta, GA 30308 | 2019-12-02 |
| 1639728207 | Shannon Oliver Sullivan | Counselor | 1 Baltimore Pl Nw, Suite 360, Atlanta, GA 30308 | 2019-09-06 |
| 1477110187 | Ariel Alibey | Preventive Medicine | 550 Peachtree St Ne Bldg 4th, Atlanta, GA 30308 | 2019-05-29 |
| 1972075497 | Laura Mcrae | Nurse Practitioner | Emory Center for Critical Care, 550 Peachtree Street, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-21 |
| 1265902134 | Kyle Brooks Kraft | Nurse Practitioner | 550 Peachtree Road, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-04 |
| 1396211025 | Vita Judkins | Pharmacist | 240 Renaissance Pkway Ne, Unit 116, Atlanta, GA 30308 | 2018-10-20 |
| 1407345911 | Caitlin Cundiff | Anesthesiology | 550 Peachtree St Ne Ste 3245b, Atlanta, GA 30308 | 2018-05-09 |
| Find all providers in zip 30308 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750862389 | Pediatric and Adult Surgery Center of Atlanta LLC | Clinic/Center | 2061 Peachtree Rd Ne Ste 300-a, Atlanta, GA 30309-1447 | 2018-08-22 |
| 1891286860 | Sandy Springs Center for Urologic Surgery LLC | Clinic/Center | 1450 S Johnson Ferry Rd Ste 100, Atlanta, GA 30319 | 2018-05-24 |
| 1316435779 | Summit Surgery Center of Buckhead LLC | Clinic/Center | 2045 Peachtree Rd Ne Ste T2, Atlanta, GA 30309-1405 | 2018-05-01 |
| 1679007108 | Ear Nose and Throat Facial Plastics and Sleep Disorder Ascllc | Clinic/Center | 601 Pryor St Sw, Atlanta, GA 30312 | 2017-04-11 |
| 1295288751 | Plastic Head and Neck Surgery Institute | Clinic/Center | 5730 Glenridge Dr Ste T150, Atlanta, GA 30328-5872 | 2016-08-01 |
| 1659755692 | The Spine Institute of Peachtree Neurosurgery, LLC | Clinic/Center | 1150 Hammond Dr Ste E600, Atlanta, GA 30328-8604 | 2015-07-18 |
| 1831576891 | Advanced Surgery Center Perimeter, LLC | Clinic/Center | 1100 Johnson Fy Rd Ne Ste 300, Atlanta, GA 30342-1733 | 2015-04-29 |
| 1841459211 | Aasc, LLC | Clinic/Center | 4200 Northside Pkwy Nw Bldg 8, Atlanta, GA 30327-3054 | 2008-06-02 |
| 1922131770 | Northside Womens Clinic Inc | Clinic/Center | 3543 Chamblee Dunwoody Road, Atlanta, GA 30341-2454 | 2007-03-13 |
| 1780715219 | Gyn Resources, Inc | Clinic/Center | 987 Chattahoochee Ave Nw, Suite A, Atlanta, GA 30318-3701 | 2007-03-08 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.