NORTH GEORGIA UROLOGY CENTER, PC, INC – Urology Physician, NPI 1861413197

NORTH GEORGIA UROLOGY CENTER, PC, INC is a healthcare provider. based in Dalton, Georgia. specializing in Urology Physician. The organization holds a License No. 050482 (GA). The NPI Number for NORTH GEORGIA UROLOGY CENTER, PC, INC is 1861413197

Main info

Organization
Name
NORTH GEORGIA UROLOGY CENTER, PC, INC
NPI
1861413197
Phone
(706) 278-5961
Address
1434 BROADRICK DRIVE
Authorized Official
CLISTA TALLENT PRACTICE MANAGER
Enumeration Date
21 July 2006
Last Update Date
4 October 2018
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for NORTH GEORGIA UROLOGY CENTER, PC, INC

  • North Georgia Urology Center, 1434, Broadrick Drive, Dalton, Whitfield County, Georgia, 30720, United States

    DALTON, GA 307203009

    Phone: (706) 278-5961

    Fax: (706) 275-0280

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-10-04

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-09-30 (990 days ago).

Enrollment records

2

Earliest due date

2023-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040706000589OClinic/Group PracticeGA2023-09-30
O20101004000422OPhysician - UrologyGA2024-06-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30720)

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Reviews

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Frequently asked questions

How do payers reference NORTH GEORGIA UROLOGY CENTER, PC, INC?
For NORTH GEORGIA UROLOGY CENTER, PC, INC, use NPI 1861413197 as the unique 10-digit identifier.
Active or inactive — what applies to NORTH GEORGIA UROLOGY CENTER, PC, INC?
You should see NORTH GEORGIA UROLOGY CENTER, PC, INC as active in CMS-hosted NPPES data.
What area of care is associated with NORTH GEORGIA UROLOGY CENTER, PC, INC?
NORTH GEORGIA UROLOGY CENTER, PC, INC's record emphasizes Urology Physician. Clinical services aligned with this taxonomy classification.
Is NORTH GEORGIA UROLOGY CENTER, PC, INC associated with Dalton?
Public fields place NORTH GEORGIA UROLOGY CENTER, PC, INC around Dalton, Georgia. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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