NORTH GEORGIA UROLOGY CENTER, PC, INC (NPI# 1861413197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861413197 |
| Entity Type | Organization |
| Organization Name | NORTH GEORGIA UROLOGY CENTER, PC, INC |
| Practice Address |
1434 Broadrick Drive North Georgia Urology Center Dalton GA 30720 |
| Mailing Address |
1434 Broadrick Drive Dalton GA 30720-3009 |
| Practice Telephone | 7062785961 |
| Practice Fax Number | 7062750280 |
| Mailing Telephone | 7062785961 |
| Mailing Fax Number | 7062750280 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2018-10-04 |
| Authorized Official Name | CLISTA TALLENT (PRACTICE MANAGER) |
| Authorized Official Telephone | 7062785961 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 050482 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 429126502A | 05 | |
| GA | 8913681 | 05 | |
| GA | 00931312A | 05 |
| Street Address |
1434 BROADRICK DRIVE NORTH GEORGIA UROLOGY CENTER |
| City | DALTON |
| State | GA |
| Zip Code | 30720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688421 | Nighat Purnima Kabir | Student in an Organized Health Care Education/Training Program | Hamilton Medical Center, Attn: Residency Program, 1200 Memorial Drive, Dalton, GA 30720 | 2020-04-21 |
| 1720620727 | Elizabeth Nicole Gregory | Behavioral Analyst | 1201 Burleyson Rd., Dalton, GA 30720 | 2019-10-10 |
| 1972161768 | Andrea Nicole Henry | Speech-Language Pathologist | 1201 Burleyson Road, Dalton, Ga. 30720, Dalton, GA 30720 | 2019-06-05 |
| 1275056905 | Cynthia L Wood | Speech-Language Pathologist | 1011 Professional Blvd., Dalton, GA 30720 | 2017-07-25 |
| 1073069225 | Alyssa Sellers Garner | Nurse Practitioner | 1436 Chattanooga Avenue, Dalton, GA 30720 | 2016-08-28 |
| 1588039077 | Katie Walker | Social Worker | 900 Shugart Road, Dalton, GA 30720 | 2015-12-09 |
| 1215310800 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 98 West Walnut Ave, Dalton, GA 30720 | 2015-07-01 |
| 1275969081 | Stacy Kay Whitehead | Nurse Practitioner | 1411 Chattanooga Avenue, Suite 101, Dalton, GA 30720 | 2013-09-25 |
| 1821439985 | Chantal Aneka Raheeda Lewis | Internal Medicine | 1109 Burleyson Rd Ste 103, Dalton, GA 30720 | 2013-07-17 |
| 1174960678 | Homestead Hospice of Northwest Georgia, LLC | Hospice Care, Community Based | 1601 Hickory Street, Dalton, GA 30720 | 2013-05-24 |
| Find all providers in zip 30720 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295200426 | Paul Edward Henson Jr. | Urology | 1837 Wood Valley Dr, Dalton, GA 30720-3846 | 2018-10-03 |
| 1316943210 | Charles B Idom Jr. | Urology | 1434 Broadrick Dr, Dalton, GA 30720-3009 | 2005-06-24 |
| 1467458364 | James E Mckinney | Urology | 1008 Professional Blvd, Dalton, GA 30720-2554 | 2005-06-24 |
| 1033580295 | North Georgia Urology Center | Urology | 1434 Broadrick Dr, Dalton, GA 30720-3009 | 2015-10-14 |
| 1881960003 | Urology Associates, LLC | Urology | 1008 Professional Blvd, Sute 6, Dalton, GA 30720-2554 | 2012-04-02 |
| 1861464208 | Joseph Anthony Veys | Urology | 1434 Broadrick Dr, Dalton, GA 30720-3009 | 2006-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820576 | Advanced Urology Institute of Georgia PC | Urology | 2205 Riverstone Blvd Ste 101, Canton, GA 30114-5250 | 2020-04-23 |
| 1093369795 | Georgia Urology, Pa | Urology | 470 Northside Cherokee Blvd Ste 210, Canton, GA 30115-8029 | 2019-07-31 |
| 1790248953 | Michael Oberle | Urology | 1120 15th St Rm Baa 8415, Augusta, GA 30912-4050 | 2019-04-12 |
| 1598220915 | Effingham Urology, LLC | Urology | 613 Towne Park Dr W Ste 204, Rincon, GA 31326-5183 | 2019-02-11 |
| 1275008351 | Center for Special Surgery LLC | Urology | 11660 Alpharetta Hwy Ste 720, Roswell, GA 30076-4916 | 2018-10-04 |
| 1477033124 | Urological Health Center, PC | Urology | 1770 Watson Boulevard, Warner Robins, GA 31093 | 2018-08-21 |
| 1982182655 | Advanced Urology Institute of Georgia | Urology | 1460 S Johnson Ferry Rd, Atlanta, GA 30319-4301 | 2018-08-03 |
| 1922597517 | Wguasc, LLC | Urology | 150 Clinic Ave Ste 203, Carrollton, GA 30117-4402 | 2018-05-09 |
| 1841788395 | Houston Physician Specialists, LLC | Urology | 233 N Houston Rd Ste 100, Warner Robins, GA 31093-8944 | 2018-04-30 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| Find all providers with the same taxonomy | ||||
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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.