NPIMap

Organization Active NPI

Southeast Lung & Critical Care Specialists

  • Pulmonary Disease Physician
  • Baxley, GA
National Provider Identifier
1053640367
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
032635 Issued in GA
Legal business name
SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS
Practice address
163 E Tollison St
Baxley, GA 31513-0120
Phone
(912) 354-6614
Fax
(912) 356-9078
NPI assigned
Dec 15, 2009
Last updated
Dec 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Authorized official

Name
April Young
Title
Practice Manager
Phone
(912) 354-6614

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Specialist (PhD)Group: 193200000X MULTI-SPECIALTY GROUP 173F00000X 032635 GA
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 032635 GA Primary

Addresses

Primary practice location

163 E Tollison St
Baxley, GA 31513-0120

Mailing address

340 Eisenhower Dr
BLDG. 1500
Savannah, GA 31406-1600
Phone (912) 354-6614

National Provider Directory

National Provider Directory
Tax ID family
Southeast Lung Associates40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1053640367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 EISENHOWER DR",
            "address_2": "BLDG. 1500",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061600",
            "telephone_number": "912-354-6614",
            "fax_number": "912-356-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 E TOLLISON ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130120",
            "telephone_number": "912-354-6614",
            "fax_number": "912-356-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "912-354-6614"
    },
    "taxonomies": [
        {
            "code": "173F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Sleep Specialist, PhD",
            "state": "GA",
            "license": "032635",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "032635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxley, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.