Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Southern Surgical Assistants LLC

Organization Nurse Practitioner · NPI 1417224650

Southern Surgical Assistants LLC provides Nurse Practitioner services in Cumming, Georgia. Licensed in Georgia. Registered with an NPI since 2011.

Licensed in
GA
In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1200 Northside Forsyth Dr
Cumming, GA 30041-7659 Not confirmed with CMS for 11 years — call before visiting
Phone: (770) 844-3200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN177592 (GA)

Record details

NPI number1417224650
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joseph Kanclerz — Ceo · (678) 591-8344
NPI enumeratedNovember 16, 2011
Last updated in NPPESSeptember 17, 2015
Mailing addressPo Box 7042, Chestnut Mountain, GA 30502-0042

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