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360 UROLOGY
NPI 1871336669
Urology in Stockbridge, GA

Active since June 18, 2024CLIA 11D2308483 · Waiver
175 COUNTRY CLUB DR STE 300-E, STOCKBRIDGE, GA 30281(678) 941-4140(678) 941-4139 Get Directions Write a Review

NPPES record last updated: July 26, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 26, 2024, Jun 18, 2024 (2 updates tracked since 2024).

About 360 Urology NPPES

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

360 UROLOGY (NPI 1871336669) is a healthcare organization registered as an urology in Stockbridge, Georgia and active in the NPI registry since June 2024. The organization holds a CLIA Waiver certificate valid through July 29, 2028 and lists Bhavik B Shah, Owner, as its authorized official.

NPPES Registry Identity

NPI1871336669
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business Name360 UROLOGY
Location Address175 COUNTRY CLUB DR STE 300-EStockbridge, GA 30281-9054
Mailing Address175 Country Club Dr Ste 300-eStockbridge, GA 30281-9054 · (678) 941-4140 · Fax (678) 941-4139
Phone(678) 941-4140
Fax(678) 941-4139
Organization SubpartNo
Authorized OfficialBhavik B ShahOwner · (813) 842-5956
Enumeration DateJune 18, 2024
Last NPPES UpdateJuly 26, 20242 updates tracked since enumeration
NPPES CertifiedJuly 26, 2024
✔ NPI 1871336669 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.
175 COUNTRY CLUB DR STE 300-E, Stockbridge, GA 30281
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

360 Urology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to 360 Urology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Bhavik Shah, M.D.
Urology
NPI 1265774863
175 COUNTRY CLUB DR STE 300-E
Stockbridge, GA 30281
(678) 941-4140
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 11D2308483

360 Urology · Stockbridge, GA
Active · expires Jul 29, 2028
CLIA Number11D2308483
Laboratory TypePhysician Office
Certificate Effective DateJuly 30, 2026
Certificate Expiration DateJuly 29, 2028
Laboratory DirectorBhavik B. Shah
Laboratory Phone(678) 941-4140
Laboratory Location360 Urology175 Country Club Drive, Suite 300-E, Stockbridge, GA 30281
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 360 Urology's NPI number?

The NPI number for 360 Urology is 1871336669. It was assigned to this organization in the NPPES registry on June 18, 2024.

Where is 360 Urology located?

360 Urology is located at 175 Country Club Dr Ste 300-E, Stockbridge, GA 30281. The listed phone number is (678) 941-4140.

What is 360 Urology's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is 360 Urology enrolled in Medicare?

Yes. 360 Urology is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through 360 Urology?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Urology) reassigns their Medicare billing to 360 Urology. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does 360 Urology hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2308483) is associated with this NPI, valid through July 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for 360 Urology was last updated on July 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.