Southeast Internal Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOUTHEAST INTERNAL MEDICINE PC

Practice address

406 Riverside Dr
Waycross, GA 31501-5315

Phone

(912) 287-1555

NPI assigned

Jul 21, 2006

Organization subpart

No

Name

Pauline M Bellecci, MD

Title

Physician

Phone

(912) 287-1555

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

• Shawn Agee, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Jacksonville, FL
  • NPI 1114247079
  NPD (past)
• John P Sullivan, MD

  • Ophthalmology Physician
  • Jacksonville, FL
  • NPI 1619977345
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 5, 2014.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1104847607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 777",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315020777",
            "telephone_number": "912-287-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 RIVERSIDE DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015315",
            "telephone_number": "912-287-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "BELLECCI",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "912-287-1555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GRP642",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA MEDICARE",
            "identifier": "CC4999",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Georgia Health Services, L.L.C.
• Southeast Georgia Health Services, L.L.C.
• Southeast Georgia Mobile Therapy
• Southeast Georgia Pediatrics
• Southeast Georgia Primary Care
• Southeast Lung & Critical Care Specialists, PC
• Southeast Lung and Critical Care Specialist
• Southeastern Chiropractic
• Southern Anesthesia Company, LLC.
• Southern Georgia Regional Commission

• All providers in Waycross, GA
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.