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GEORGIA UROLOGY PA
NPI 1508081795
Urology in Douglasville, GA

Active since April 15, 2007CLIA 11D2100885 · Microscopy
4645 TIMBER RIDGE DR STE 120, DOUGLASVILLE, GA 30135(770) 942-2478(678) 631-4986 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 6, 2026, Nov 4, 2020 (2 updates tracked since 2020).

About Georgia Urology Pa NPPES

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

GEORGIA UROLOGY PA (NPI 1508081795) is a healthcare organization registered as an urology in Douglasville, Georgia and active in the NPI registry since April 2007. The organization holds a CLIA Microscopy certificate valid through August 24, 2027 and lists Dan Fellner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1508081795
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameGEORGIA UROLOGY PA
Location Address4645 TIMBER RIDGE DR STE 120Douglasville, GA 30135-7542
Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040 · Fax (678) 284-4076
Phone(770) 942-2478
Fax(678) 631-4986
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 1508081795 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.
4645 TIMBER RIDGE DR STE 120, Douglasville, GA 30135
Open in Google Maps ↗

Other Identifiers 1

Other11D0980072GA · 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

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 for Provider-Performed Microscopy Procedures (PPMP) 11D2100885

Georgia Urology · Douglasville, GA
Active · expires Aug 24, 2027
CLIA Number11D2100885
Laboratory TypePhysician Office
Certificate Effective DateAugust 25, 2025
Certificate Expiration DateAugust 24, 2027
Laboratory DirectorCharles R. Kaplan
Laboratory Phone(404) 292-0094
Laboratory LocationGeorgia Urology4645 Timber Ridge Drive Suite 120, Douglasville, GA 30135
CLIA data matches this NPI record on: Address Name
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

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

NATALIE PHUONG PHAM AGACNP-BC
Nurse Practitioner (Acute Care)
4645 TIMBER RIDGE DR STE 120
DOUGLASVILLE, GA 30135
Douglas County (770) 942-2478

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 1508081795. 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 4645 Timber Ridge Dr Ste 120, Douglasville, GA 30135. The listed phone number is (770) 942-2478.

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 for Provider-Performed Microscopy Procedures (PPMP) (number 11D2100885) is associated with this NPI, valid through August 24, 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.