NPIMap

Organization Active NPI

Burke Hospital Company

Doing business as Southeastern Spine and Pain

  • Multi-Specialty Clinic/Center
  • Springfield, GA
National Provider Identifier
1104550342
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BURKE HOSPITAL COMPANY
Doing business as
Southeastern Spine and Pain
Practice address
459 Hwy 119 S
Springfield, GA 31329-3021
Phone
(912) 542-0444
Fax
(833) 639-1102
NPI assigned
Jul 13, 2022
Last updated
Oct 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Authorized official

Name
Michael S Hester
Title
Ceo
Phone
(912) 369-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

459 Hwy 119 S
Springfield, GA 31329-3021

Mailing address

459 Hwy 119 S
Springfield, GA 31329-3021

Other names 1

  • Southeastern Spine and Pain Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220411001540 GA Part B Supplier - Clinic/Group Practice 3476956012 Receives reassigned benefits from 18 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springfield, GA; Waynesboro, GA; Thomson, GA; Swainsboro, GA; Statesboro, GA; Sandersville, GA; Millen, GA; Louisville, GA

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Spine and Pain20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 1

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": "1657670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1104550342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 HWY 119 S",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313293021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 HWY 119 S",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313293021",
            "telephone_number": "912-542-0444",
            "fax_number": "833-639-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURKE HOSPITAL COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "HESTER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-369-9400"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Spine and Pain",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeastern Spine and Pain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.