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GEORGIA UROLOGY, PA
NPI 1003428590
Urology in Cumming, GA

Active since August 18, 2020CLIA Certified · 2 labs
4150 DEPUTY BILL CANTRELL MEMORIAL RD., SUITE 140A, CUMMING, GA 30040(770) 889-9737 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 6, 2026, Aug 18, 2020 (2 updates tracked since 2020).

About Georgia Urology, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GEORGIA UROLOGY, PA (NPI 1003428590) is a healthcare organization registered as an urology in Cumming, Georgia and active in the NPI registry since August 2020. The organization holds 2 active CLIA laboratory certificates and lists Dan Fellner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003428590
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameGEORGIA UROLOGY, PA
Location Address4150 DEPUTY BILL CANTRELL MEMORIAL RD., SUITE 140ACumming, GA 30040
Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040
Phone(770) 889-9737
Organization SubpartYes
Authorized OfficialDan FellnerCeo · (678) 205-8360
Enumeration DateAugust 18, 2020
Last NPPES UpdateMay 6, 20262 updates tracked since enumeration
NPPES CertifiedMay 6, 2026
✔ NPI 1003428590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition

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.

4150 DEPUTY BILL CANTRELL MEMORIAL RD., Cumming, GA 30040
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Other Names 1

Other NameForsyth Procedure Room

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D0943323

Georgia Urology PA Cumming · Cumming, GA
Active · expires Mar 24, 2028
CLIA Number11D0943323
Laboratory TypePhysician Office
Certificate Effective DateMarch 25, 2026
Certificate Expiration DateMarch 24, 2028
Laboratory DirectorCarl C. Capelouto
Laboratory Phone(770) 889-9737
Laboratory LocationGeorgia Urology PA Cumming1800 Northside Forsyth Drive Suite 370, Cumming, GA 30041
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D0714543

Georgia Urology - Nst · Atlanta, GA
Active · expires Feb 28, 2027
CLIA Number11D0714543
Laboratory TypePhysician Office
Certificate Effective DateMarch 1, 2025
Certificate Expiration DateFebruary 28, 2027
Laboratory DirectorDr. Mark Haber
Laboratory Phone(678) 284-4040
Laboratory LocationGeorgia Urology - Nst5730 Glenridge Dr Suite 200, Atlanta, GA 30328
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTOPHER STEVEN BLANCHARD D.O.
Orthopaedic Surgery
4150 DEPUTY BILL CANTRELL MEMORIAL RD., STE. 300
CUMMING, GA 30040
Forsyth County (770) 886-8111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Georgia Urology, PA's NPI number?

The NPI number for Georgia Urology, PA is 1003428590. It was assigned to this organization in the NPPES registry on August 18, 2020. The provider is also known as Forsyth Procedure Room.

Where is Georgia Urology, PA located?

Georgia Urology, PA is located at 4150 Deputy Bill Cantrell Memorial Rd. Suite 140A, Cumming, GA 30040. The listed phone number is (770) 889-9737.

What is Georgia Urology, PA's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Does Georgia Urology, PA hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Georgia Urology, PA was last updated on May 6, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.