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GEORGIA UROLOGY PA
NPI 1245455435
Urology in Conyers, GA

Active since April 15, 2007CLIA 11D1094215 · Waiver
1301 SIGMAN RD NE STE 250A, CONYERS, GA 30012(770) 760-9900(770) 760-1709 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, May 22, 2018 (2 updates tracked since 2018).

About Georgia Urology Pa NPPES

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

GEORGIA UROLOGY PA (NPI 1245455435) is a healthcare organization registered as an urology in Conyers, Georgia and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through January 13, 2027 and lists Dan Fellner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1245455435
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameGEORGIA UROLOGY PA
Location Address1301 SIGMAN RD NE STE 250AConyers, GA 30012
Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040 · Fax (678) 284-4076
Phone(770) 760-9900
Fax(770) 760-1709
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 1245455435 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.
1301 SIGMAN RD NE STE 250A, Conyers, GA 30012
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Other Identifiers 1

Other11D0949726GA · 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 of Waiver 11D1094215

Georgia Urology PA Rockdale Ambulatory Surgery Center · Conyers, GA
Active · expires Jan 13, 2027
CLIA Number11D1094215
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJanuary 14, 2025
Certificate Expiration DateJanuary 13, 2027
Laboratory DirectorAllen Futral
Laboratory Phone(770) 760-9900
Laboratory LocationGeorgia Urology PA Rockdale Ambulatory Surgery Center1301 Sigman Road, Suite 260, Conyers, GA 30012
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D0949726

Georgia Urology PA - Rockdale · Conyers, GA
Expired · Aug 9, 2026
CLIA Number11D0949726
Laboratory TypePhysician Office
Certificate Effective DateAugust 10, 2024
Certificate Expiration DateAugust 9, 2026
Laboratory DirectorBert T. Chen
Laboratory Phone(770) 760-9900
Laboratory LocationGeorgia Urology PA - Rockdale1301 Sigman Road, Suite 250 A, Conyers, GA 30012
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 3

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

ALLEN A FUTRAL III M.D.
Urology
1301 SIGMAN RD NE STE 250A
CONYERS, GA 30012
Rockdale County (770) 760-9900
GEORGIA UROLOGY PIEDMONT, LLC
Urology
1301 SIGMAN RD NE STE 250A
CONYERS, GA 30012
Rockdale County (770) 760-9900
BERT TSI CHEN M.D.
Urology
1301 SIGMAN RD NE STE 250A
CONYERS, GA 30012
Rockdale County (770) 760-9900

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 1245455435. 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 1301 Sigman Rd NE Ste 250A, Conyers, GA 30012. The listed phone number is (770) 760-9900.

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 of Waiver (number 11D1094215) is associated with this NPI, valid through January 13, 2027. 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.