1. Home
  2. Directory
  3. Georgia
  4. Canton
  5. Urology
  6. NPI Profile

GEORGIA UROLOGY, PA
NPI 1093369795
Urology in Canton, GA

Active since July 31, 2019CLIA 11D0943320 · Microscopy
470 NORTHSIDE CHEROKEE BLVD STE 210, CANTON, GA 30115(770) 720-7246 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 6, 2026, Aug 26, 2020, Jul 31, 2019 (3 updates tracked since 2019).

About Georgia Urology, Pa NPPES

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

GEORGIA UROLOGY, PA (NPI 1093369795) is a healthcare organization registered as an urology in Canton, Georgia and active in the NPI registry since July 2019. The organization holds a CLIA Microscopy certificate valid through March 24, 2028 and lists Dan Fellner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1093369795
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameGEORGIA UROLOGY, PA
Location Address470 NORTHSIDE CHEROKEE BLVD STE 210Canton, GA 30115-8029
Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040
Phone(770) 720-7246
Organization SubpartYesParent: Georgia Urology Pa
Authorized OfficialDan FellnerCeo · (678) 205-8360
Enumeration DateJuly 31, 2019
Last NPPES UpdateMay 6, 20263 updates tracked since enumeration
NPPES CertifiedMay 6, 2026
✔ NPI 1093369795 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.
470 NORTHSIDE CHEROKEE BLVD STE 210, Canton, GA 30115
Open in Google Maps ↗

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

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) 11D0943320

Georgia Urology PA, Canton · Canton, GA
Active · expires Mar 24, 2028
CLIA Number11D0943320
Laboratory TypePhysician Office
Certificate Effective DateMarch 25, 2026
Certificate Expiration DateMarch 24, 2028
Laboratory DirectorJoel A. Rosenfield
Laboratory Phone(770) 720-7246
Laboratory LocationGeorgia Urology PA, Canton470 Northside Cherokee Boulevard, Suite 210, Canton, GA 30115
CLIA data matches this NPI record on: Address 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.

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 1093369795. It was assigned to this organization in the NPPES registry on July 31, 2019.

Where is Georgia Urology, PA located?

Georgia Urology, PA is located at 470 Northside Cherokee Blvd Ste 210, Canton, GA 30115. The listed phone number is (770) 720-7246.

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 a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D0943320) is associated with this NPI, valid through March 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Georgia Urology, PA was last updated on May 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.