NPIMap

Organization Active NPI

Southern Surgical Specialties, LLC

  • Surgery Physician
  • Cordele, GA
National Provider Identifier
1023419736
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
046072 Issued in GA
Legal business name
SOUTHERN SURGICAL SPECIALTIES, LLC
Practice address
307 E 3Rd Ave
Cordele, GA 31015-3208
Phone
(229) 271-4620
Fax
(229) 271-4614
NPI assigned
Sep 12, 2014
Last updated
Jan 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Vincent S Culpepper, M.D.
Title
Surgeon
Phone
(229) 938-4931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 046072 GA Primary

Addresses

Primary practice location

307 E 3Rd Ave
Cordele, GA 31015-3208

Mailing address

PO Box 1135
Cordele, GA 31010-1135
Phone (229) 276-2004

National Provider Directory

National Provider Directory

Locations

307 E 3rd Ave
Cordele, GA 31015
Phone (229) 271-4612

Practitioners & affiliated clinicians

Practitioners 3

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": "1410480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1023419736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1135",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310101135",
            "telephone_number": "229-276-2004",
            "fax_number": "229-276-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E 3RD AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153208",
            "telephone_number": "229-271-4620",
            "fax_number": "229-271-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SURGICAL SPECIALTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-12",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "CULPEPPER",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "229-938-4931",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "046072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordele, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.