CELEBRITY BODY SCULPTING AND COSMETIC SURGERY CENTER NPI 1710337134

Surgery (Plastic and Reconstructive Surgery) in Union City, GA

Organization Surgery Plastic and Reconstructive Surgery CLIA Number 11D2116522 CLIA Certificate of Waiver

About CELEBRITY BODY SCULPTING AND COSMETIC SURGERY CENTER

Celebrity Body Sculpting And Cosmetic Surgery Center is a provider established in Union City, Georgia specializing in surgery (plastic and reconstructive surgery) . The NPI number of Celebrity Body Sculpting And Cosmetic Surgery Center is 1710337134 and was assigned on June 2016. The practitioner's primary taxonomy code is 2086S0122X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Celebrity Body Sculpting And Cosmetic Surgery Center operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Anishua M Roberts (Operations Manager)

The CLIA number of Celebrity Body Sculpting And Cosmetic Surgery Center is 11D2116522 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Celebrity Body Sculpting And Cosmetic Surgery 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.

NPI

1710337134

Provider NameCELEBRITY BODY SCULPTING AND COSMETIC SURGERY CENTER
Provider Location Address4550 JONESBORO RD SUITE K UNION CITY, GA 30291
Provider Mailing Address4550 JONESBORO RD SUITE K UNION CITY, GA 30291
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date06-16-2016
Last Update Date06-16-2016

Primary Taxonomy

Taxonomy Code2086S0122X
ClassificationSurgery
TypeAllopathic & Osteopathic Physicians
SpecializationPlastic and Reconstructive Surgery
Taxonomy DescriptionA surgeon who specializes in plastic and reconstructive surgery.

Business Address

CELEBRITY BODY SCULPTING AND COSMETIC SURGERY CENTER
4550 JONESBORO RD
SUITE K
UNION CITY, GA
ZIP 30291
Phone: (678) 515-4607
Fax: (470) 355-8524

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Mailing Address

CELEBRITY BODY SCULPTING AND COSMETIC SURGERY CENTER
4550 JONESBORO RD
SUITE K
UNION CITY, GA
ZIP 30291
Phone: (678) 515-4607
Fax: (470) 355-8524

Authorized Official

Authorized Official Name ANISHUA M ROBERTS
Authorized Official TitleOPERATIONS MANAGER
Authorized Official Phone(678) 515-4607

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 the NPI number 1710337134 is:

CLIA Number11D2116522
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003448044 SEUNGHYUN LEE PHARMD
Individual
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)4550 JONESBORO RD
UNION CITY, GA 30291
(770) 969-0267
1083968481HE CARES MEDICAL WALK IN CLINIC LLC
Organization
General Practice4550 JONESBORO RD SUITE K
UNION CITY, GA 30291
(678) 665-9180
1235202896DR. MELISSA GARRETT HILL D.M.D.
Individual
Dentist4550 JONESBORO RD SUITE A-1
UNION CITY, GA 30291
(770) 306-2266
1386678266THE KROGER CO
Organization
Pharmacy (Community/Retail Pharmacy)4550 JONESBORO RD
UNION CITY, GA 30291
(770) 969-0267
1598782450 ALFONSO C FINDLEY MD
Individual
General Practice4550 JONESBORO RD SUITE K
UNION CITY, GA 30291
(678) 665-9180

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.