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PLASTIC SURGERY CENTER OF THE SOUTH
NPI 1295885465
Clinic/Center in Marietta, GA

Active since January 11, 2007CLIA 11D2050208 · Waiver
120 VANN ST NE, SUITE 150, MARIETTA, GA 30060(772) 421-1242(770) 424-6652 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Plastic Surgery Center Of The South NPPES

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

PLASTIC SURGERY CENTER OF THE SOUTH (NPI 1295885465) is a healthcare organization registered as a clinic/center in Marietta, Georgia and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through November 20, 2026 and lists James Edgar Leake, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1295885465
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePLASTIC SURGERY CENTER OF THE SOUTH
Location Address120 VANN ST NE, SUITE 150Marietta, GA 30060-7250
Mailing Address120 Vann St Ne, Suite 150Marietta, GA 30060-7250 · (772) 421-1242 · Fax (770) 424-6652
Phone(772) 421-1242
Fax(770) 424-6652
Organization SubpartNo
Authorized OfficialJames Edgar LeakeMedical Director · (770) 421-1242
Enumeration DateJanuary 11, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1295885465 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in GA · 261QA1903X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
120 VANN ST NE, Marietta, GA 30060
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Mending Health.Insurance ›

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 11D2050208

Plastic Surgery Center Of The South · Marietta, GA
Active · expires Nov 20, 2026
CLIA Number11D2050208
Laboratory TypePhysician Office
Certificate Effective DateNovember 21, 2024
Certificate Expiration DateNovember 20, 2026
Laboratory DirectorCorey E. Harkins
Laboratory Phone(770) 421-1242
Laboratory LocationPlastic Surgery Center Of The South120 Vann Street, Suite 150, Marietta, GA 30060
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

MR. MICHAEL PETROSKY MD
Surgery (Plastic and Reconstructive Surgery)
120 VANN ST NE, STE 150
MARIETTA, GA 30060
Cobb County (770) 421-1242
COREY PATRICK HARKINS
Surgery (Plastic and Reconstructive Surgery)
120 VANN ST NE, SUITE 150
MARIETTA, GA 30060
Cobb County (770) 421-1242
MICHAEL PETROSKY
Surgery (Plastic and Reconstructive Surgery)
120 VANN ST NE, SUITE 150
MARIETTA, GA 30060
Cobb County (770) 421-1242
ELMER ANTHONY MUSARRA II
Surgery (Plastic and Reconstructive Surgery)
120 VANN ST NE, SUITE 150
MARIETTA, GA 30060
Cobb County (770) 421-1242
JAMES LEAKE
Surgery (Plastic and Reconstructive Surgery)
120 VANN ST NE, SUITE 150
MARIETTA, GA 30060
Cobb County (770) 421-1242

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 Plastic Surgery Center Of The South's NPI number?

The NPI number for Plastic Surgery Center Of The South is 1295885465. It was assigned to this organization in the NPPES registry on January 11, 2007.

Where is Plastic Surgery Center Of The South located?

Plastic Surgery Center Of The South is located at 120 Vann St NE Suite 150, Marietta, GA 30060. The listed phone number is (772) 421-1242.

What is Plastic Surgery Center Of The South's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Plastic Surgery Center Of The South hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2050208) is associated with this NPI, valid through November 20, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Plastic Surgery Center Of The South accept?

Health plans from Mending Health list Plastic Surgery Center Of The South as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Plastic Surgery Center Of The South was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.