ELO OUTPATIENT SURGERY CENTER LLC (NPI# 1912240003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912240003 |
| Entity Type | Organization |
| Organization Name | ELO OUTPATIENT SURGERY CENTER LLC |
| Practice Address |
4050 Riverside Dr Macon GA 31210-1805 |
| Mailing Address |
840 Pine Street 900 Macon GA 31201-5100 |
| Practice Telephone | 4787462888 |
| Practice Fax Number | 4787462889 |
| Mailing Telephone | 4787462888 |
| Mailing Fax Number | 4787462889 |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2013-03-27 |
| Authorized Official Name | DR. NNAEMEKA M UMERAH (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4787462888 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
63974 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003000004B | 05 |
| Street Address |
4050 RIVERSIDE DR |
| City | MACON |
| State | GA |
| Zip Code | 31210-1805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003986761 | Anayo Umerah | Family Medicine | 4050 Riverside Dr, Suite B, Macon, GA 31210-1805 | 2006-11-09 |
| 1104469295 | First Look Opticians | Durable Medical Equipment & Medical Supplies | 4050 Riverside Dr, Macon, GA 31210-1805 | 2019-10-22 |
| 1437714425 | Vision Eye Surgery Center | Clinic/Center | 4050 Riverside Dr, Macon, GA 31210-1805 | 2019-05-05 |
| 1013471721 | Vision Eye Group | Ophthalmology | 4050 Riverside Dr, Macon, GA 31210-1805 | 2019-01-27 |
| 1215456561 | Stephanie Ard | Nurse Practitioner | 4050 Riverside Dr, Macon, GA 31210-1805 | 2017-09-18 |
| 1073051850 | Fabeola Sepolen | Obstetrics & Gynecology | 4050 Riverside Dr, Macon, GA 31210-1805 | 2017-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1871124735 | Jessica Bello | Nurse Practitioner | 5300 Bowman Road, Macon, GA 31210 | 2020-01-30 |
| 1225505787 | Rebekah Hollinshead | Occupational Therapist | Therapy Specialists of Georgia, 4116 Arkwright Road, Macon, GA 31210 | 2018-11-01 |
| 1346744943 | Ace Medical Transport LLC. | Ambulance | 728 Gay Dr, Macon, GA 31210 | 2018-03-20 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1083074868 | Macon Dentist Office, PC | Dentist | 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 | 2016-03-07 |
| 1992176952 | Kerisia Wasztyl | Marriage & Family Therapist | 4691 Pine Valley Dr, Macon, GA 31210 | 2015-10-15 |
| 1073905444 | Eunice Malave De Leon | Social Worker | 174 Spring St, Macon, GA 31210 | 2015-02-23 |
| 1396141545 | Axis Surgery Center LLC | Clinic/Center | 230 Sheraton Blvd, Ste B, Macon, GA 31210 | 2014-11-17 |
| 1073914115 | Monique Rechelle Delay Moore | Community/Behavioral Health | 646 Millrun Court, Macon, GA 31210 | 2014-09-09 |
| Find all providers in zip 31210 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396141545 | Axis Surgery Center LLC | Clinic/Center | 230 Sheraton Blvd, Ste B, Macon, GA 31210 | 2014-11-17 |
| 1467851758 | Macon Outpatient Surgery, LLC | Clinic/Center | 1610 Forysth Street, Macon, GA 31201 | 2014-08-22 |
| 1427307578 | Hemlock Ambulatory Surgery Center | Clinic/Center | 101 Preston Ct Ste 104, Macon, GA 31210-5771 | 2012-09-05 |
| 1134367642 | Preferred Medical Billing | Clinic/Center | 4039 Mickey St, Macon, GA 31206-3952 | 2009-01-22 |
| 1356497747 | Associates Surgery Center, Inc. | Clinic/Center | 864 1st St, Macon, GA 31201-6875 | 2007-01-26 |
| 1659426385 | Forsyth Street Ambulatory Surgery Center, LLC | Clinic/Center | 1610 Forsyth Street, Macon, GA 31201 | 2007-01-24 |
| 1952319378 | Surgical Centers of Ga PC | Clinic/Center | 3556 Riverside Dr, Macon, GA 31210-2509 | 2006-08-03 |
| 1386673044 | Urology Center of Georgia LLC | Clinic/Center | 1870 Hardeman Ave, Macon, GA 31201-1161 | 2006-07-02 |
| 1609872597 | Coliseum Same Day Surgery Center Lp | Clinic/Center | 340 Hospital Dr, Bldg E, Macon, GA 31217-3838 | 2005-06-24 |
| 1831746007 | Gc Surgery Center LLC | Clinic/Center | 6326 Peake Rd, Macon, GA 31210-3960 | 2019-08-22 |
| Find all providers in MACON | ||||
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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.