MEDICARE: AURA UROLOGICAL CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1447102694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AURA UROLOGICAL CARE LLC

Provider Business Mailing Address
First Line	:	8735 DUNWOODY PL STE R
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30350-2995
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8735 DUNWOODY PL STE R
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30350-2995
Country	:	US
Telephone Number	:	470-801-5700
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	BRIAN CLUKIE
Credential	:
Telephone Number	:	813-388-2935

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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