PA-C SURGICAL ASSIST, LLC (NPI# 1801413174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801413174 |
| Entity Type | Organization |
| Organization Name | PA-C SURGICAL ASSIST, LLC |
| Practice Address |
520 W Ponce Leon Ave #1706 Decatur GA 30030 |
| Mailing Address |
Po Box 1706 Decatur GA 30031-1706 |
| Practice Telephone | 4049073292 |
| Mailing Telephone | 4049073292 |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2020-07-02 |
| Authorized Official Name | TIFFANY GIBBERT (OWNER) |
| Authorized Official Telephone | 4049073292 |
| Authorized Official Credential | PA |
| 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 |
520 W PONCE LEON AVE #1706 |
| City | DECATUR |
| State | GA |
| Zip Code | 30030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| 1417468638 | Deborah Korzun | Physical Therapist | 6303 Jefferson Square Ct, Decatur, GA 30030 | 2017-10-15 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699328369 | Georgia Urology, Pa | Clinic/Center | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-07-22 |
| 1568984375 | American Access Care of Atlanta Asc LLC | Clinic/Center | 250 E Ponce Deleon Avenue, Suite 100, Decatur, GA 30030-3406 | 2017-07-13 |
| 1194255372 | Decatur Urology Surgery Center | Clinic/Center | 2711 Irvin Way Ste 101, Decatur, GA 30030 | 2017-06-19 |
| 1962513788 | Surgery Center of Decatur Lp | Clinic/Center | 1122 14th Avenue Se, Decatur, AL 35601-3361 | 2006-08-31 |
| 1891716049 | Georgia Urology Ambulatory Surgical Center LLC | Clinic/Center | 2685 Milscott Dr, Decatur, GA 30033-5906 | 2006-07-22 |
| 1134185564 | Decatur Digestive Disease Center LLC | Clinic/Center | 2 Memorial Dr Suite 102, Physician Plaza West, Decatur, IL 62526-3950 | 2006-04-25 |
| 1730601865 | Snapfinger Vascular Access Center Asc LLC | Clinic/Center | 5246 Snapfinger Park Dr, Decatur, GA 30035-4044 | 2017-07-11 |
| 1043660442 | Georgia Interventional Pain - D, LLC | Clinic/Center | 484 Irvin Ct, Suite 130, Decatur, GA 30030-5406 | 2016-06-16 |
| 1568705846 | Dekalb Center for Foot and Ankle Surgery, LLC | Clinic/Center | 215 Clairemont Ave, Decatur, GA 30030-2508 | 2013-04-04 |
| 1922262278 | Eps Surgical Center, LLC | Clinic/Center | 1457 Scott Blvd, Decatur, GA 30030-1425 | 2008-07-16 |
| Find all providers in DECATUR | ||||
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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.