NPIMap

Organization Active NPI

Palliative Care Consultants of Southeast Georgia, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Brunswick, GA
National Provider Identifier
1003164468
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
065178 Issued in GA
Legal business name
PALLIATIVE CARE CONSULTANTS OF SOUTHEAST GEORGIA, LLC
Practice address
1692 Glynco Parkway
Suite 100
Brunswick, GA 31525
Phone
(912) 289-9200
NPI assigned
Aug 16, 2012
Last updated
Aug 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John ShanerNPI 1285624411
Title
John Shaner, MD
Phone
(912) 289-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 065178 GA Primary

Addresses

Primary practice location

1692 Glynco Parkway
Suite 100
Brunswick, GA 31525

Mailing address

1692 Glynco Parkway
Suite 100
Brunswick, GA 31525
Phone (912) 289-9200

National Provider Directory

National Provider Directory

Locations

1692 Glynco Pkwy
Ste 100
Brunswick, GA 31525
Phone (912) 289-9200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345420800000",
    "number": "1003164468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 GLYNCO PARKWAY",
            "address_2": "SUITE 100",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31525",
            "telephone_number": "912-289-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1692 GLYNCO PARKWAY",
            "address_2": "SUITE 100",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31525",
            "telephone_number": "912-289-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALLIATIVE CARE CONSULTANTS OF SOUTHEAST GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-20",
        "status": "A",
        "authorized_official_last_name": "SHANER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "JOHN SHANER, MD",
        "authorized_official_telephone_number": "912-289-9200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "065178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.