Southern Podiatry Group, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

SOUTHERN PODIATRY GROUP, PC

Practice address

820 Love Ave
Suite B
Tifton, GA 31794-4071

Phone

(229) 382-5599

NPI assigned

May 22, 2008

Organization subpart

No

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

Authorized official

Name

Avis Griffin

Title

Office Manager

Phone

(229) 242-3668

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Southern Podiatry Group, PC

  • Foot & Ankle Surgery Podiatrist
  • Valdosta, GA
  • NPI 1144352956

  O20040507000537

  Same enrollment

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy E Pitts, DPM

  • Foot & Ankle Surgery Podiatrist
  • Valdosta, GA
  • NPI 1952361024
  NPD (past)
• Hoeung Moeung Chov, DPM

  • Podiatrist
  • Downey, CA
  • NPI 1194826024
  NPD (past)
• David G Cox Jr., D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Lynchburg, VA
  • NPI 1770543852
  NPD (past)
• Eric Joseph Thomas, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Greenville, SC
  • NPI 1306107313
  NPD (past)

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1013174457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2718 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 LOVE AVE",
            "address_2": "SUITE B",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944071",
            "telephone_number": "229-382-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PODIATRY GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "AVIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "229-242-3668"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300026567A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Home Care Services, Inc.
• Southern Home Medical LLC
• Southest Lung & Critical Care Specialists
• Southwell Ambulatory Inc
• Southwell Pharmacy
• Southwest Georgia Rehab, Inc
• Southwestern State Hospital

• Foot & Ankle Surgery Podiatrist in Tifton, GA
• Providers in Tifton, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.