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GEORGIA UROLOGY PA
NPI 1053536243
Urology in Lawrenceville, GA

Active since April 15, 2007CLIA Certified · 2 labs
850 LAWRENCEVILLE SUWANEE RD STE 101, LAWRENCEVILLE, GA 30043(770) 963-2451(770) 962-0017 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, Dec 14, 2022 (2 updates tracked since 2022).

About Georgia Urology Pa NPPES

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

GEORGIA UROLOGY PA (NPI 1053536243) is a healthcare organization registered as an urology in Lawrenceville, Georgia and active in the NPI registry since April 2007. The organization holds 2 active CLIA laboratory certificates and lists Dan Fellner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053536243
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameGEORGIA UROLOGY PA
Location Address850 LAWRENCEVILLE SUWANEE RD STE 101Lawrenceville, GA 30043-5483
Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040 · Fax (678) 284-4076
Phone(770) 963-2451
Fax(770) 962-0017
Organization SubpartYes
Authorized OfficialDan FellnerCeo · (678) 205-8360
Enumeration DateApril 15, 2007
Last NPPES UpdateMay 6, 20262 updates tracked since enumeration
NPPES CertifiedMay 6, 2026
✔ NPI 1053536243 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.

850 LAWRENCEVILLE SUWANEE RD STE 101, Lawrenceville, GA 30043
Open in Google Maps ↗

Other Identifiers 1

Other11D0258125GA · Clia

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) 11D2131838

Georgia Urology - Braselton · Braselton, GA
Active · expires Jun 6, 2027
CLIA Number11D2131838
Laboratory TypePhysician Office
Certificate Effective DateJune 7, 2025
Certificate Expiration DateJune 6, 2027
Laboratory DirectorBrent Sharpe
Laboratory Phone(770) 963-2451
Laboratory LocationGeorgia Urology - Braselton1223 Friendship Road, Bldg 400, Suite 100, Braselton, GA 30517
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) 11D2310664

Georgia Urology Ambulatory Surgery Center · Braselton, GA
Active · expires Sep 8, 2026
CLIA Number11D2310664
Laboratory TypePhysician Office
Certificate Effective DateSeptember 9, 2024
Certificate Expiration DateSeptember 8, 2026
Laboratory DirectorBrent Sharpe
Laboratory Phone(770) 963-2451
Laboratory LocationGeorgia Urology Ambulatory Surgery Center1223 Friendship Road, Bldg 400,suite 110, Braselton, GA 30517
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 8

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

DR. ARMAN CICIC D.O.
Urology
850 LAWRENCEVILLE SUWANEE RD STE 101
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 963-2451
DR. CHRISTOPHER JOON KI KIM MD, PHARMD
Urology
850 LAWRENCEVILLE SUWANEE RD STE 101
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 963-2451
CELINE NGUYEN
Physician Assistant
850 LAWRENCEVILLE SUWANEE RD STE 101
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 963-2451
KEYONA N KING-OSIS PA-C, PHD
Physician Assistant
850 LAWRENCEVILLE SUWANEE RD STE 101
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 963-2451
JEREMY KENT WU CERTIFIED PA
Physician Assistant
850 LAWRENCEVILLE SUWANEE RD STE 101
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 963-2451
MRS. SOUMI SAHA
Physician Assistant
850 LAWRENCEVILLE SUWANEE RD STE 101
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 963-2451
VY THI TUONG VO PA-C
Physician Assistant
850 LAWRENCEVILLE SUWANEE RD STE 101
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 963-2451
OSTAP DOVIRAK M.D.
Urology
850 LAWRENCEVILLE SUWANEE RD STE 101
LAWRENCEVILLE, GA 30043
Gwinnett County (770) 963-2451

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 1053536243. It was assigned to this organization in the NPPES registry on April 15, 2007.

Where is Georgia Urology PA located?

Georgia Urology PA is located at 850 Lawrenceville Suwanee Rd Ste 101, Lawrenceville, GA 30043. The listed phone number is (770) 963-2451.

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.