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MACON OUTPATIENT SURGERY INC
NPI 1104072453
Clinic/Center - Ambulatory Surgical in Macon, GA

Active since August 18, 2008CLIA 11D0954707 · Waiver
3708 NORTHSIDE DR, MACON, GA 31210(478) 745-4206(478) 254-5463 Get Directions Write a Review

NPPES record last updated: January 3, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Macon Outpatient Surgery Inc NPPES

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

MACON OUTPATIENT SURGERY INC (NPI 1104072453) is a healthcare organization registered as an ambulatory surgical in Macon, Georgia and active in the NPI registry since August 2008. The organization holds a CLIA Waiver certificate valid through December 6, 2026 and lists Georgia Lee, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1104072453
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameMACON OUTPATIENT SURGERY INC
Location Address3708 NORTHSIDE DRMacon, GA 31210-2404
Mailing Address3708 Northside DrMacon, GA 31210-2404 · (478) 745-4206 · Fax (478) 254-5463
Phone(478) 745-4206
Fax(478) 254-5463
Organization SubpartNo
Authorized OfficialGeorgia LeeChief Operating Officer · (478) 745-4206
Enumeration DateAugust 18, 2008
Last NPPES UpdateJanuary 3, 2012
✔ NPI 1104072453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
3708 NORTHSIDE DR, Macon, GA 31210
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Other Identifiers 2

Medicaid00821697AGA
Medicare UPINX47053GA

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 11D0954707

Macon Outpatient Surgery LLC · Macon, GA
Active · expires Dec 6, 2026
CLIA Number11D0954707
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateDecember 7, 2024
Certificate Expiration DateDecember 6, 2026
Laboratory DirectorLynn W. Johnson
Laboratory Phone(478) 254-5410
Laboratory LocationMacon Outpatient Surgery LLC3708 Northside Drive, Macon, GA 31210
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

DR. WALDO EMERSON FLOYD III MD
Orthopaedic Surgery (Hand Surgery)
3708 NORTHSIDE DR
MACON, GA 31210
Bibb County (478) 745-4206
CLAYTON WALTER GUTHRIE III PA-C
Physician Assistant
3708 NORTHSIDE DR
MACON, GA 31210
Bibb County (478) 745-4206
RYAN EDWARD SCHNETZER MD
Orthopaedic Surgery
3708 NORTHSIDE DR
MACON, GA 31210
Bibb County (478) 745-4206
PAIGE PARKER D.P.T
Physical Therapist
3708 NORTHSIDE DR
MACON, GA 31210
Bibb County (478) 745-4206
MRS. KAREN T CLUBB NP
Nurse Practitioner (Family)
3708 NORTHSIDE DR
MACON, GA 31210
Bibb County (478) 745-4206
LAUREN COLEMAN PT, DPT
Physical Therapist (Orthopedic)
3708 NORTHSIDE DR
MACON, GA 31210
Bibb County (478) 745-4206
DAVID BRUCE PA
Physician Assistant
3708 NORTHSIDE DR
MACON, GA 31210
Bibb County (478) 254-5303
LAUREN CLARK
Nurse Practitioner
3708 NORTHSIDE DR
MACON, GA 31210
Bibb County (478) 745-4206

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 Macon Outpatient Surgery Inc's NPI number?

The NPI number for Macon Outpatient Surgery Inc is 1104072453. It was assigned to this organization in the NPPES registry on August 18, 2008.

Where is Macon Outpatient Surgery Inc located?

Macon Outpatient Surgery Inc is located at 3708 Northside Dr, Macon, GA 31210. The listed phone number is (478) 745-4206.

What is Macon Outpatient Surgery Inc's specialty?

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

Does Macon Outpatient Surgery Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0954707) is associated with this NPI, valid through December 6, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Macon Outpatient Surgery Inc was last updated on January 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.