Southern Surgical Assistants, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

SOUTHERN SURGICAL ASSISTANTS, LLC

Practice address

5742 Allee Way
Braselton, GA 30517

Phone

(678) 591-8344

Fax

(770) 965-3365

NPI assigned

Apr 28, 2008

Organization subpart

No

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

Authorized official

Name

Joseph Henry Kanclerz, ARNP, RNFANPI 1164697355

Title

Owner

Phone

(678) 591-8644

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 3

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

• Joseph Henry Kanclerz, MSN, NP-C, RNFA

  • Nurse Practitioner
  • Braselton, GA
  • NPI 1164697355
  Medicare reassignment NPD Authorized official
• Hugh Colby Cornelson, FNP-C

  • Family Nurse Practitioner
  • Gainesville, GA
  • NPI 1053899682
  NPD
• Macy Elizabeth Fortner

  • Acute Care Nurse Practitioner
  • Dawsonville, GA
  • NPI 1154950905
  NPD

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543363200000",
    "number": "1063687267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7042",
            "city": "CHESTNUT MOUNTAIN",
            "state": "GA",
            "postal_code": "305020042",
            "telephone_number": "678-591-8344",
            "fax_number": "770-965-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5742 ALLEE WAY",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "30517",
            "telephone_number": "678-591-8344",
            "fax_number": "770-965-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SURGICAL ASSISTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2018-11-28",
        "status": "A",
        "authorized_official_last_name": "KANCLERZ",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-591-8644",
        "authorized_official_credential": "ARNP, RNFA"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Tyler Skipper, MD
• Allison A Smith, PA
• Sumona Smith
• Christopher William Soika, MD
• Something 2 Smile About LTD Co
• Specialty Orthopaedics, PC
• Specialty Spine and Pain, PC
• Patrick Speck, MD
• Spine Solutions LLC
• Kandis Stallings, OTC

• Nurse Practitioner in Braselton, GA
• Providers in Braselton, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.