NPIMap

Organization Active NPI

Southland Taylor Hospitalist Group, LLC

  • Hospitalist Physician
  • Hawkinsville, GA
National Provider Identifier
1093120909
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
SOUTHLAND TAYLOR HOSPITALIST GROUP, LLC
Practice address
222 Perry Hwy
Hawkinsville, GA 31036-6748
Phone
(478) 783-0200
NPI assigned
Jun 30, 2014
Last updated
May 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Authorized official

Name
Stephanie Fletcher
Title
Cfo
Phone
(229) 236-0831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X NU Primary

Addresses

Primary practice location

222 Perry Hwy
Hawkinsville, GA 31036-6748

Mailing address

PO Box 102545
Atlanta, GA 30368-2545
Phone (800) 261-0048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140922002775 GA Part B Supplier - Clinic/Group Practice 6800015959 Receives reassigned benefits from 31 practitioners
Practice locations: Hawkinsville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559001600000",
    "number": "1093120909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102545",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682545",
            "telephone_number": "800-261-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PERRY HWY",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310366748",
            "telephone_number": "478-783-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND TAYLOR HOSPITALIST GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2019-05-28",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-236-0831"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.