LOCUST GROVE ENDO CENTER (NPI# 1023134640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023134640 |
| Entity Type | Organization |
| Organization Name | LOCUST GROVE ENDO CENTER |
| Practice Address |
4865 Bill Gardner Parkway Locust Grove GA 30248 |
| Practice Telephone | 7706920100 |
| Mailing Telephone | 7706920100 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ARUNA R PRAKASH (ADMINISTRATOR) |
| Authorized Official Telephone | 7706920100 |
| Authorized Official Credential | B.SC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
4865 BILL GARDNER PARKWAY |
| City | LOCUST GROVE |
| State | GA |
| Zip Code | 30248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467622779 | Samyukta Chava | Internal Medicine | 4865 Bill Gardner Parkway, Locust Grove, GA 30248 | 2008-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346809779 | Uyen Nguyen | Dentist | 4146 Ga-42, Locust Grove, GA 30248 | 2019-06-10 |
| 1669038303 | Monique Antoinette Joseph | Nurse Practitioner | 3334 Highway 155 Ste B, Locust Grove, GA 30248 | 2019-05-17 |
| 1811552524 | Fresenius Medical Care Locust Grove, LLC | Clinic/Center | 2855 Ga-155 S, Locust Grove, GA 30248 | 2019-05-08 |
| 1972167765 | Wesley Todd Livingston | Pharmacist | 2730 Ga 155, Locust Grove, GA 30248 | 2019-04-26 |
| 1053974550 | Wish You Well Youth Faith Foundation Inc | Contractor | 147 Laughlin Dr, Locust Grove, GA 30248 | 2019-04-19 |
| 1740776517 | Takle Eye Surgery Center LLC | Clinic/Center | 1075 Bandy Pkwy, Ste 105, Locust Grove, GA 30248 | 2018-07-05 |
| 1508357559 | Justin Robert Crumpton | Behavioral Analyst | 212 Westin Park Dr, Locust Grove, GA 30248 | 2018-05-25 |
| 1730679051 | Lisa Renee Jones | Family Medicine | 3778 G 42, Locus Grove, GA 30248 | 2018-05-11 |
| 1275042152 | Stephanie Jones Headen | Counselor | 211 Peeksville Rd., Locust Grove, GA 30248 | 2017-09-23 |
| 1942735592 | Brandi Nicole Buice Minter | Pharmacist | 4920 Bill Gardner Parkway, Locust Grove, GA 30248 | 2017-04-20 |
| Find all providers in zip 30248 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740776517 | Takle Eye Surgery Center LLC | Clinic/Center | 1075 Bandy Pkwy, Ste 105, Locust Grove, GA 30248 | 2018-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372963 | Alliance Surgery Center At Peachtree City LLC | Clinic/Center | 1975 Highway 54 W Ste 105, Peachtree City, GA 30269-4794 | 2020-09-29 |
| 1518579903 | Amin Surgery Center for Women LLC | Clinic/Center | 1150b Kirkland Ln, Douglas, GA 31533-2044 | 2020-08-18 |
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1720602683 | Georgia Eye Surgery LLC | Clinic/Center | 1620 Prince Ave Ste B, Athens, GA 30606-6008 | 2020-06-05 |
| 1750905618 | Rsps Fayetteville Asc Lllp | Clinic/Center | 874 Lanier Ave W Ste 270, Fayetteville, GA 30214-7617 | 2020-06-05 |
| 1699395541 | Medici Surgical Center Gwinnett, LLC | Clinic/Center | 2220 Wisteria Dr Ste 100, Snellville, GA 30078-4604 | 2020-04-21 |
| 1114552338 | Georgia Interventional Pain - G, LLC | Clinic/Center | 1504 N Thornton Ave Ste 104, Dalton, GA 30720-8394 | 2020-03-09 |
| 1700424322 | Georgia Interventional Pain - F, LLC | Clinic/Center | 1357 Hembree Rd Ste 230, Roswell, GA 30076-5725 | 2019-12-13 |
| 1699328369 | Georgia Urology, Pa | Clinic/Center | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-07-22 |
| 1912563941 | Commerce Ambulatory Surgery Center, Inc. | Clinic/Center | 417 Pottery Factory Dr, Commerce, GA 30529-6682 | 2019-05-15 |
| Find all providers with the same taxonomy | ||||
| City | LOCUST GROVE |
| Zip Code | 30248 |
Please comment or provide details below to improve the information on LOCUST GROVE ENDO CENTER.
| 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.