NORTH FULTON ENDOSCOY CENTER
NPI 1487639100
Clinic/Center - Endoscopy in Roswell, GA
- Organization
- Clinic/Center
- Endoscopy
- CLIA Number: 11D2281103
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-01-2027
About NORTH FULTON ENDOSCOY CENTER
This page provides the complete NPI Profile along with additional information for North Fulton Endoscoy Center, a provider established in Roswell, Georgia operating as a Clinic/center, focusing in endoscopy . The healthcare provider is registered in the NPI registry with number 1487639100 assigned on December 2005. The practitioner's primary taxonomy code is 261QE0800X with license number 060091 (GA). The provider is registered as an organization and their NPI record was last updated 15 years ago. The provider's is doing business as North Fulton Endoscoy Center. The authorized official of this NPI record is Jana Baker (Administrator)
- NPI
- 1487639100 Verify this NPI
- Provider Legal Name
- NORTH FULTON DIAGNOSTIC GASTROINTESTINAL CENTER
- Other Organization Name
- NORTH FULTON ENDOSCOY CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1340 UPPER HEMBREE RD ROSWELL, GA 30076
- Location Phone
- (678) 762-0676
- Location Fax
- (678) 762-7980
- Mailing Address
- 550 PEACHTREE ST NE SUITE 1600 ATLANTA, GA 30308
- Mailing Phone
- (404) 888-7575
- Mailing Fax
- (404) 885-7777
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-15-2005
- Last Update Date
- 08-24-2011
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Endoscopy
- Taxonomy Code
- 261QE0800X
- Type
- Ambulatory Health Care Facilities
- License No.
- 060091
- License State
- GA
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| X17830 | MEDICARE UPIN (02) | GA | |
| 111063ASCA | MEDICARE ID-TYPE UNSPECIFIED (04) | GA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2281103
- Facility Type
- Physician Office
- Certificate Effective Date
- May 02, 2025
- Certificate Expiration Date
- May 01, 2027
- Laboratory Director
- ASHLEY PHELPS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to North Fulton Endoscoy Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
ROSWELL, GA 30076
ROSWELL, GA 30076
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1487639100, enumerated as an "organization" on December 15, 2005.
The provider is located at 1340 UPPER HEMBREE RD ROSWELL, GA 30076 and the phone number is (678) 762-0676.
Clinic/Center with taxonomy code 261QE0800X and a focus in Endoscopy.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
