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GEORGIA UROLOGY NORTHEAST LLC
NPI 1205643897
Urology in Braselton, GA

Active since December 17, 2024
1223 FRIENDSHIP RD., BLDG. 400, SUITE 100, BRASELTON, GA 30517(678) 205-8387 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 6, 2026, Dec 17, 2024 (2 updates tracked since 2024).

About Georgia Urology Northeast Llc NPPES

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

GEORGIA UROLOGY NORTHEAST LLC (NPI 1205643897) is a healthcare organization registered as an urology in Braselton, Georgia and active in the NPI registry since December 2024. The organization lists Dan Fellner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1205643897
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameGEORGIA UROLOGY NORTHEAST LLC
Location Address1223 FRIENDSHIP RD., BLDG. 400, SUITE 100Braselton, GA 30517
Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040
Phone(678) 205-8387
Organization SubpartYesParent: Georgia Urology, Pa
Authorized OfficialDan FellnerCeo · (678) 284-4040
Enumeration DateDecember 17, 2024
Last NPPES UpdateMay 6, 20262 updates tracked since enumeration
NPPES CertifiedMay 6, 2026
✔ NPI 1205643897 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.
1223 FRIENDSHIP RD., Braselton, GA 30517
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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

Other Providers at the Same Location NPPES 4

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

GEORGIA UROLOGY, PA
Urology
1223 FRIENDSHIP RD., BLDG. 400, SUITE 110
BRASELTON, GA 30517
Jackson County (770) 963-2451
GEORGIA UROLOGY PA
Urology
1223 FRIENDSHIP RD., BLDG. 400 SUITE 100
BRASELTON, GA 30517
Jackson County (678) 205-8387
DR. MICHAEL RAYMOND BUTZEN DNP
Nurse Practitioner (Acute Care)
1223 FRIENDSHIP RD., BLDG. 400, SUITE 100
BRASELTON, GA 30517
Jackson County (678) 205-8387
GEORGIA UROLOGY, PA
Clinic/Center (Ambulatory Surgical)
1223 FRIENDSHIP RD., BLDG. 400, SUITE 110
BRASELTON, GA 30517
Jackson 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 Northeast LLC's NPI number?

The NPI number for Georgia Urology Northeast LLC is 1205643897. It was assigned to this organization in the NPPES registry on December 17, 2024.

Where is Georgia Urology Northeast LLC located?

Georgia Urology Northeast LLC is located at 1223 Friendship Rd. Bldg. 400, Suite 100, Braselton, GA 30517. The listed phone number is (678) 205-8387.

What is Georgia Urology Northeast LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Georgia Urology Northeast LLC 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 2 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.