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LOCUST GROVE ENDO CENTER
NPI 1023134640
Clinic/Center - Ambulatory Surgical in Locust Grove, GA

Active since March 22, 2007CLIA 11D1072745 · Waiver
4865 BILL GARDNER PARKWAY, LOCUST GROVE, GA 30248(770) 692-0100 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Locust Grove Endo Center NPPES

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

LOCUST GROVE ENDO CENTER (NPI 1023134640) is a healthcare organization registered as an ambulatory surgical in Locust Grove, Georgia and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through August 22, 2027 and lists Aruna R Prakash, Administrator, as its authorized official.

NPPES Registry Identity

NPI1023134640
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameLOCUST GROVE ENDO CENTER
Location Address4865 BILL GARDNER PARKWAYLocust Grove, GA 30248
Mailing Address4865 Bill Gardner ParkwayLocust Grove, GA 30248 · (770) 692-0100
Phone(770) 692-0100
Organization SubpartNo
Authorized OfficialAruna R PrakashAdministrator · (770) 692-0100
Enumeration DateMarch 22, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1023134640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
4865 BILL GARDNER PARKWAY, Locust Grove, GA 30248
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 of Waiver 11D1072745

Locust Grove Endo Center · Locust Grove, GA
Active · expires Aug 22, 2027
CLIA Number11D1072745
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateAugust 23, 2025
Certificate Expiration DateAugust 22, 2027
Laboratory DirectorJay Prakash
Laboratory Phone(770) 692-0100
Laboratory LocationLocust Grove Endo Center4865 Bill Gardner Parkway, Locust Grove, GA 30248
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
162 services161 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
120 services114 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
90 services88 patients
Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249
This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.
23 services23 patients
Diagnostic exam of large bowel using a flexible endoscope 45378
This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.
17 services17 patients
Injection beneath lining of large bowel using a flexible endoscope 45381
This procedure involves a flexible tube, called an endoscope, being inserted into the large bowel. A small needle is then passed through the tube to inject medication under the bowel lining. This is typically done to treat inflammation or bleeding.
17 services16 patients

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 Locust Grove Endo Center's NPI number?

The NPI number for Locust Grove Endo Center is 1023134640. It was assigned to this organization in the NPPES registry on March 22, 2007.

Where is Locust Grove Endo Center located?

Locust Grove Endo Center is located at 4865 Bill Gardner Parkway, Locust Grove, GA 30248. The listed phone number is (770) 692-0100.

What is Locust Grove Endo Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Locust Grove Endo Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1072745) is associated with this NPI, valid through August 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Locust Grove Endo Center accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list Locust Grove Endo Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Locust Grove Endo Center was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.