KEJ SURGICAL SERVICES LLC (NPI# 1235676495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235676495 |
| Entity Type | Organization |
| Organization Name | KEJ SURGICAL SERVICES LLC |
| Practice Address |
2770 Holly Ridge Cir Marietta GA 30062-4602 |
| Mailing Address |
Po Box 670132 Marietta GA 30066-0119 |
| Practice Telephone | 2142272457 |
| Practice Fax Number | 2147640880 |
| Mailing Telephone | 2142272457 |
| Mailing Fax Number | 2147640880 |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |
| Authorized Official Name | MR. MICHAEL E JOHNSON (OWNER) |
| Authorized Official Telephone | 2142272457 |
| Authorized Official Credential | SAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
16-399 | GA | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
2770 HOLLY RIDGE CIR |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-4602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 246ZC0007X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Assistant |
| A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. |
| Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818422 | Lisa M Arey | Specialist/Technologist, Other | 2429 Salem Ct Sw, Marietta, GA 30064-4259 | 2020-07-21 |
| 1003448911 | Kirstin Gabler | Specialist/Technologist, Other | 2119 Wilshire Dr Sw, Marietta, GA 30064-4197 | 2020-02-08 |
| 1114374287 | Michael Johnson | Specialist/Technologist, Other | 2886 Sandy Plains Rd, Marietta, GA 30066-0240 | 2016-05-19 |
| 1184007668 | Victoria Cochran | Specialist/Technologist, Other | 833 Campbell Hill St Nw Ste 280, Marietta, GA 30060-1162 | 2015-07-02 |
| 1811508658 | Seba Surgical Assisting, LLC | Specialist/Technologist, Other | 2429 Salem Ct Sw, Marietta, GA 30064-4259 | 2020-08-14 |
| 1750910246 | Morgan Holnaider | Specialist/Technologist, Other | 800 Kennesaw Ave Nw Ste 130, Marietta, GA 30060-1052 | 2020-04-06 |
| 1144863614 | Catherine Collins | Specialist/Technologist, Other | 833 Campbell Hill St Nw Ste 280, Marietta, GA 30060-1162 | 2019-10-28 |
| 1700366606 | Jaime Lynn Buckelew | Specialist/Technologist, Other | 800 Kennesaw Ave Nw Ste 120, Marietta, GA 30060-1052 | 2018-08-20 |
| 1326527409 | Brittany Nicole Crowder | Specialist/Technologist, Other | 800 Kennesaw Ave Nw Ste 120, Marietta, GA 30060-1052 | 2018-08-09 |
| 1225566540 | Joshua Stewart Tatum | Specialist/Technologist, Other | 833 Campbell Hill St Nw Ste 280, Marietta, GA 30060-1162 | 2017-05-31 |
| Find all providers in MARIETTA | ||||
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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.