| NPI | 1356630990 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2011-04-05 |
| Last Updated | 2025-06-02 |
| Authorized Official | Jorge Hernandez VP of Admin Services and CCO Phone: 4048516378 |
| Mailing Address | 1000 Johnson Ferry Rd Ne Atlanta, GA 30342-1606 United States Phone: (404) 851-8000 📍 View Map |
| Primary Practice Address | 1000 Johnson Ferry Rd Ne Atlanta, GA 30342-1606 United States Phone: (855) 709-4535 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | - | 193400000X | Taxonomy |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 208600000X – Surgery | - | - |
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →
About NPI 1356630990
Northside Surgical Professional Services Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1356630990. The primary specialty listed is Surgery. The organization is located in Atlanta, GA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2011-04-05. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1356630990?
NPI 1356630990 belongs to Northside Surgical Professional Services Llc, a Surgery in Atlanta, GA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1356630990 active?
The current status of NPI 1356630990 in the NPPES registry is Active. The record was last updated on 2025-06-02.
What specialty is NPI 1356630990?
NPI 1356630990 is classified under the taxonomy Surgery. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1356630990?
You can verify NPI 1356630990 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1356630990?
The primary practice address on file for NPI 1356630990 is 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342-1606. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1356630990 issued?
NPI 1356630990 was first issued (enumerated) on 2011-04-05. The NPPES record was last updated on 2025-06-02.
Practice Location Map
Northside Surgical Professional Services Llc is located at 1000 Johnson Ferry Rd Ne, Atlanta, GA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Northside Surgical Professional Services Llc. All records sourced from the CMS NPPES registry.