GEORGIA UROLOGY, PA (NPI# 1003428590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003428590 |
| Entity Type | Organization |
| Organization Name | GEORGIA UROLOGY, PA |
| Practice Address |
4150 Deputy Bill Cantrell Memorial Rd. Suite 140a Cumming GA 30040 |
| Mailing Address |
1930 Brannan Rd Mcdonough GA 30253-4310 |
| Practice Telephone | 7708899737 |
| Mailing Telephone | 6782844040 |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |
| Authorized Official Name | MARK A HABER (MANAGING PARTNER) |
| Authorized Official Telephone | 6782844040 |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA UROLOGY, PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Forsyth Procedure Room | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093369795 | Georgia Urology, Pa | Urology | 470 Northside Cherokee Blvd Ste 210, Canton, GA 30115-8029 | 2019-07-31 |
| 1699328369 | Georgia Urology, Pa | Clinic/Center | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-07-22 |
| 1952771230 | Georgia Urology, Pa | Clinic/Center | 3400 Old Milton Pkwy Ste C535, Alpharetta, GA 30005-4456 | 2015-09-30 |
| 1629222815 | Georgia Urology, Pa | Clinic/Center | 1301 Sigman Rd Ne Ste 250b, Conyers, GA 30012-3812 | 2008-11-14 |
| 1245875236 | Georgia Urology, Pa | Urology | 631 Professional Dr Ste 490, Lawrenceville, GA 30046-3370 | 2019-11-13 |
| 1083268783 | Georgia Urology, Pa | Urology | 120 Trinity Pl, Athens, GA 30607-2100 | 2019-07-31 |
| 1639499627 | Georgia Urology, Pa | Clinic/Center | 790 Church St Ne, Suite 430, Marietta, GA 30060-7282 | 2010-06-02 |
| Street Address |
4150 DEPUTY BILL CANTRELL MEMORIAL RD. SUITE 140A |
| City | CUMMING |
| State | GA |
| Zip Code | 30040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942592613 | Christopher Steven Blanchard | Orthopaedic Surgery | 4150 Deputy Bill Cantrell Memorial Rd., Ste. 300, Cumming, GA 30040 | 2011-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427684729 | Am Nollenberger Counseling | Counselor | 327 Dahlonega Street Ste 901 A, Cumming, GA 30040 | 2020-03-18 |
| 1497388904 | Ben Allen Sanders | Pharmacist | Kroger Pharmacy 627, 5550 Bethelview Road, Cumming, GA 30040 | 2020-02-13 |
| 1407415615 | Jacqueline Small | Nurse Practitioner | 407 W Maple St # 101, Cumming, GA 30040 | 2019-06-11 |
| 1336706316 | Mary Kathleen Hesidence | Nurse Practitioner | 81 Northside Dr, #100, Dawsonville, GA 30040 | 2019-05-24 |
| 1851958334 | North Georgia Pathology | Pathology | 4150 Deputy Bill Cantrell Memorial Rd Suite 200, Cumming, GA 30040 | 2019-05-21 |
| 1598320087 | Emily Rebecca Downs | Physician Assistant | 3970 Deputy Bill Cantrell Memorial Road Ste 150, Cumming, GA 30040 | 2019-05-09 |
| 1215490057 | Shine Speech Language Therapy LLC | Speech-Language Pathologist | 107 Pilgrim Village Dr Suite 400, Cumming, GA 30040 | 2019-04-09 |
| 1417430075 | Ashley Michelle Nollenberger | Counselor | 327 Dahlonega Street, Ste 901 A, Cumming, GA 30040 | 2018-09-10 |
| 1518445410 | Village Pediatrics At Vickery | Pediatrics | 7185 Colfax Aveune, Suite 200, Cumming, GA 30040 | 2018-08-02 |
| 1306339841 | Fukuzato Eyecare, Inc | Optometrist | 3670 Hutchinson Rd Ste A&b, Cumming, GA 30040 | 2018-06-09 |
| Find all providers in zip 30040 | ||||
| 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 |
|---|---|---|---|---|
| 1700407772 | Advanced Urology Institute of Georgia, PC | Urology | 3075 Ronald Reagan Blvd Ste 501, Cumming, GA 30041-6052 | 2020-04-30 |
| 1073028643 | Georgia Urology Pa | Urology | 4150 Deputy Bill Cantrell Memorial Road, Suite 140b, Cumming, GA 30040 | 2017-12-05 |
| 1417297391 | Georgia Urology Pa | Urology | 1100 Northside Forsyth Dr, Suite 410, Cumming, GA 30041-6012 | 2013-02-28 |
| 1972728160 | Georgia Urology Pa | Urology | 1800 Northside Forsyth Dr, Suite 370, Cumming, GA 30041-8447 | 2007-04-15 |
| 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 |
| 1295200426 | Paul Edward Henson Jr. | Urology | 1837 Wood Valley Dr, Dalton, GA 30720-3846 | 2018-10-03 |
| 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 |
| 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.