GEORGIA UROLOGY PA (NPI# 1174749055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174749055 |
| Entity Type | Organization |
| Organization Name | GEORGIA UROLOGY PA |
| Practice Address |
5445 Meridian Marks Rd Ne Suite 420 Atlanta GA 30342-4763 |
| Mailing Address |
1930 Brannan Rd Mcdonough GA 30253-4310 |
| Practice Telephone | 4042525206 |
| Practice Fax Number | 4042521268 |
| Mailing Telephone | 6782844040 |
| Mailing Fax Number | 6782844076 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2015-01-28 |
| Authorized Official Name | DR. MARK A HABER (MANAGING PARTNER) |
| Authorized Official Telephone | 6782844049 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA UROLOGY PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | CLIA | 11D0694347 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265995724 | Georgia Urology Pa | Non-Pharmacy Dispensing Site | 5900 Hillandale Dr Ste 200, Lithonia, GA 30058-3858 | 2019-04-11 |
| 1447772348 | Georgia Urology Pa | Urology | 4800 Olde Towne Pkwy Ste 220, Marietta, GA 30068-4391 | 2017-07-12 |
| 1154855740 | Georgia Urology Pa | Urology | 2161 W Spring St., Suite C, Monroe, GA 30655-3196 | 2017-04-20 |
| 1720510241 | Georgia Urology Pa | Urology | 1110 W Peachtree St Nw Ste 1020, Atlanta, GA 30309-3609 | 2017-04-03 |
| 1184089989 | Georgia Urology Pa | Urology | 2151b West Spring St, Ste 210, Monroe, GA 30655-3115 | 2015-12-21 |
| 1528308988 | Georgia Urology Pa | Urology | 1357 Hembree Rd Ste 250, Roswell, GA 30076-5724 | 2013-02-21 |
| 1821261744 | Georgia Urology Pa | Urology | 200 Dawson Commons Circle, Dawsonville, GA 30534 | 2008-04-11 |
| 1508081795 | Georgia Urology Pa | Urology | 4645 Timber Ridge Dr Ste 120, Douglasville, GA 30135-7542 | 2007-04-15 |
| 1871144246 | Georgia Urology Pa | Urology | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-09-26 |
| 1073028643 | Georgia Urology Pa | Urology | 4150 Deputy Bill Cantrell Memorial Road, Suite 140b, Cumming, GA 30040 | 2017-12-05 |
| Street Address |
5445 MERIDIAN MARKS RD NE SUITE 420 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30342-4763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528053816 | Kathryn Horton Jackson | Pharmacist | 5445 Meridian Marks Rd Ne, Suite 190, Atlanta, GA 30342-4763 | 2005-09-13 |
| 1265772776 | Keri Liles | Physician Assistant | 5445 Meridian Marks Rd Ne, Suite 250, Atlanta, GA 30342-4763 | 2013-02-20 |
| 1225375652 | Brain Stimullation Clinic, LLC | Health Maintenance Organization | 5445 Meridian Marks Rd Ne, Suite 370, Atlanta, GA 30342-4763 | 2013-01-04 |
| 1487926440 | Kirsten Halle Warnock | Nurse Practitioner | 5445 Meridian Marks Rd Ne, Suite 250, Atlanta, GA 30342-4763 | 2012-02-06 |
| 1073881777 | Veronica Hill | Nurse Practitioner | 5445 Meridian Marks Rd Ne, Suite 250, Atlanta, GA 30342-4763 | 2011-12-08 |
| 1851607220 | Ashley S Reid | Registered Nurse | 5445 Meridian Marks Rd Ne, Suite 350, Atlanta, GA 30342-4763 | 2010-08-24 |
| 1659682789 | Melanie L. Turco | Nurse Practitioner | 5445 Meridian Marks Rd Ne, Ste 430, Atlanta, GA 30342-4763 | 2010-06-23 |
| 1689818312 | Piedmont Ear Nose & Throat Associates | Otolaryngology | 5445 Meridian Marks Rd Ne, Suite 125, Atlanta, GA 30342-4763 | 2009-04-24 |
| 1437319134 | Pediatric Eye Consultants of Atlanta, LLC | Ophthalmology | 5445 Meridian Marks Rd Ne, Suite 220, Atlanta, GA 30342-4763 | 2008-06-16 |
| 1689840852 | Childrens Care Pediatrics, PC | Pediatrics | 5445 Meridian Marks Rd Ne, Suite380, Atlanta, GA 30342-4763 | 2008-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
| 1255945184 | Jennifer Lynne Cole | Behavior Technician | 5555 Glenridge Con Suite 200, Atlanta, GA 30342 | 2020-09-08 |
| 1093336232 | Van Tran | Respiratory Therapist, Registered | 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 | 2020-04-28 |
| 1356978340 | Twyla Douglas Jackson I | Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 | 2020-03-27 | |
| 1760013411 | Emily Hamm | Dietitian, Registered | 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 | 2020-01-31 |
| 1043855984 | Mackenzie Tucker Wayda | Registered Nurse | 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 | 2019-11-14 |
| 1386288454 | Tiauna Lashun Cochman | Psychologist | 1307 Glenridge Dr, Sandy Springs, GA 30342 | 2019-11-01 |
| 1164074399 | Stephen J. White | Hearing Instrument Specialist | 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 | 2019-07-09 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1760954705 | Mishele Walker LLC | Counselor | 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 | 2018-12-31 |
| Find all providers in zip 30342 | ||||
| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770942856 | Georgia Urology Pediatric LLC | Urology | 5730 Glenridge Dr, Ste 200, Atlanta, GA 30328-6141 | 2016-02-17 |
| 1508125865 | Shuvro De | Urology | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2012-05-08 |
| 1912137431 | Emily Blum | Urology | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2009-07-17 |
| 1891993374 | Wolfgang Hans Cerwinka | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2007-07-06 |
| 1427152982 | Bruce H Broecker | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2006-09-12 |
| 1336243898 | Andrew J Kirsch | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2006-09-12 |
| 1699879155 | Hal C Scherz | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2006-09-12 |
| 1245334705 | Charlotte A Massad | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2006-09-12 |
| 1821019076 | Georgia Urology Pediatric LLC | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2006-07-22 |
| 1336174085 | James Michael Elmore | Urology | 5445 Meridian Marks Rd, Suite 420, Atlanta, GA 30342-4763 | 2006-07-11 |
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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.