OrganizationActive
Icon Surgical
NPI 1255003455 · Surgical Physician Assistant · Mableton, GA
Provider details
- NPI number
- 1255003455
- Entity type
- Organization
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Pamela Clay, Administrator(888) 265-9908
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
268 Saint Patrick Dr Sw
Mableton, GA 30126-1627
Phone: (678) 825-5397
Fax: (678) 426-6243
Street-level locationGet directions
Mailing address
268 Saint Patrick Dr Sw
Mableton, GA 30126-1627
Other names (DBA / former)
- Doing business as
- Icon Surgical
- Doing business as
- Icon Surgical
Registry dates
- Enumerated
- 2021-10-05
- Last updated
- 2024-03-01
- Certified
- 2024-03-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.