GEORGIA UROLOGY NORTHEAST LLC – NPI #1205643897
Urology

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.

Health Care Provider Taxonomy Code for Urology

GEORGIA UROLOGY NORTHEAST LLC is an urologist located in BRASELTON, GA. NPPES has assigned the NPI number 1205643897 to GEORGIA UROLOGY NORTHEAST LLC on December 17, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208800000X from the Health Care Provider Taxonomy code set, which is classified as Urology.

The NPI profile was last updated on May 06, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GEORGIA UROLOGY NORTHEAST LLC below.

NPI Profile for
GEORGIA UROLOGY NORTHEAST LLC

NPI Number
1205643897
Enumeration Date

(more than a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GEORGIA UROLOGY NORTHEAST LLC
Primary location
1223 FRIENDSHIP RD.
BLDG. 400, SUITE 100
BRASELTON, GA 30517
Phone: (678) 205-8387 Fax:
Mailing address
1930 BRANNAN RD
MCDONOUGH, GA 30253-4310
Phone: (678) 284-4040 Fax:
Organization Subpart
Yes - GEORGIA UROLOGY NORTHEAST LLC is subpart of another organization.
Authorized Official
DAN FELLNER
CEO
Phone: (678) 284-4040
Updated
Certification Date
May 06, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208800000X
- Urology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.