GEORGIA LITHOTRIPSY AND LASER CENTER (NPI# 1386739498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386739498 |
| Entity Type | Organization |
| Organization Name | GEORGIA LITHOTRIPSY AND LASER CENTER |
| Practice Address |
120 Trinity Pl Athens GA 30607-2100 |
| Practice Telephone | 7065432718 |
| Practice Fax Number | 7063533709 |
| Mailing Telephone | 7065432718 |
| Mailing Fax Number | 7063533709 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-11-05 |
| Authorized Official Name | DAVID C ALLEN (PRESIDENT) |
| Authorized Official Telephone | 7065432718 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| N | 261QL0400X |
Clinic/Center Specialization: Lithotripsy |
029-044 | GA | Ambulatory Health Care Facilities |
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | CHAMPUS | 581596177001 | 01 |
| GA | 00451316A | 05 | |
| GA | BLUE CROSS BLUE SHIELD | 590 | 01 |
| Street Address |
120 TRINITY PL |
| City | ATHENS |
| State | GA |
| Zip Code | 30607-2100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205834009 | Grady Elmore | Nurse Practitioner | 120 Trinity Pl, Athens, GA 30607-2100 | 2005-07-14 |
| 1083268783 | Georgia Urology, Pa | Urology | 120 Trinity Pl, Athens, GA 30607-2100 | 2019-07-31 |
| 1043718331 | Jay Rains | Physician Assistant | 120 Trinity Pl, Athens, GA 30607-2100 | 2018-02-01 |
| 1194148767 | Amanda Stephens | Nurse Practitioner | 120 Trinity Pl, Athens, GA 30607-2100 | 2014-02-01 |
| 1710145677 | The Urology Clinic | Specialist | 120 Trinity Pl, Athens, GA 30607-2100 | 2008-05-28 |
| 1265690127 | The Urology Clinic | Specialist | 120 Trinity Pl, Athens, GA 30607-2100 | 2008-05-28 |
| 1174549653 | The Urology Clinic, P.C. | Specialist | 120 Trinity Pl, Athens, GA 30607-2100 | 2006-07-15 |
| 1013916774 | Marie B Anderson | Physician Assistant | 120 Trinity Pl, Athens, GA 30607-2100 | 2005-07-15 |
| 1669471496 | David Carter Allen | Urology | 120 Trinity Pl, Athens, GA 30607-2100 | 2005-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972850055 | Junaid Nasir | Internal Medicine | 5105 Jefferson Rd Ste B, Athens, GA 30607 | 2012-08-08 |
| 1942588918 | Gustavo Figueiredo Marcondes Westin | Internal Medicine | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2011-07-25 |
| 1124164421 | Martin John Simmons | Dentist | 3380 Old Jefferson Road, Athens, GA 30607 | 2007-01-30 |
| 1518063338 | The Center for Plastic & Reconstructive Surgery, P.C. | Clinic/Center | 3320 Old Jefferson Rd., Building 100, Athens, GA 30607 | 2006-09-16 |
| 1730173352 | Mohan N Iyer | Ophthalmology | 2705 Jefferson Rd., Athens, GA 30607 | 2005-09-09 |
| 1669473245 | Angela G Stiles | Internal Medicine | 3320 Old Jefferson Road, Bldg 200 Ste A, Athens, GA 30607 | 2005-08-09 |
| 1326691171 | Teresa Rosser | Nurse Practitioner | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2019-07-22 |
| 1124501184 | Anna Cauthen Mcfather | Physician Assistant | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2018-09-14 |
| 1013498849 | Mary Rougeau Browning | Physician Assistant | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2018-08-29 |
| 1073092334 | Katelyn Taylor Gillespie | Nurse Practitioner | 3320 Old Jefferson Road, Bldg 700, Athens, GA 30607 | 2018-08-08 |
| Find all providers in zip 30607 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602683 | Georgia Eye Surgery LLC | Clinic/Center | 1620 Prince Ave Ste B, Athens, GA 30606-6008 | 2020-06-05 |
| 1649790171 | Athens Spine Procedural Center LLC | Clinic/Center | 1550 Timothy Rd Ste 103, Athens, GA 30606-7836 | 2017-06-26 |
| 1265709968 | Lumpkin Surgery Center | Clinic/Center | 1300 Crystal Hills Dr, Athens, GA 30606-5304 | 2011-11-23 |
| 1215115316 | Se Costal Laser Services, LLC | Clinic/Center | 2351 College Station Rd, Athens, GA 30605-3619 | 2008-01-31 |
| 1962453175 | The Surgery Center of Athens, LLC. | Clinic/Center | 105 N Meadows Dr, Athens, TN 37303-4172 | 2006-05-12 |
| 1033583836 | Advanced Gynecologic Surgery Center | Clinic/Center | 1000 Hawthorne Ave, Suite V, Athens, GA 30606-2168 | 2015-11-18 |
| 1700269354 | Southeast Ohio Surgical Suites, LLC | Clinic/Center | 20 University Estates Blvd, Suite 110, Athens, OH 45701-2869 | 2015-07-01 |
| 1801277819 | Hawthorne Surgery Center LLC | Clinic/Center | 1000 Hawthorne Ave, Suite U, Athens, GA 30606-2168 | 2015-06-16 |
| 1316290380 | Athens Surgery Center LLC | Clinic/Center | 105 N Meadows Dr, Athens, TN 37303-4172 | 2012-10-16 |
| 1508135658 | Surgery Center of Athens LLC | Clinic/Center | 2142 W Broad St, Suite 100, Athens, GA 30606-3546 | 2011-12-19 |
| Find all providers in ATHENS | ||||
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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.