Southern Hospital Physicians,LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

047899 Issued in GA

Legal business name

SOUTHERN HOSPITAL PHYSICIANS,LLC

Practice address

135 Blackland CT E
Marietta, GA 30067

Phone

(404) 313-0515

Fax

(678) 540-5473

NPI assigned

Apr 24, 2007

Last updated

Aug 5, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth R. Warner

Title

Manager

Phone

(404) 313-0515

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Cartersville Medical Center LLC

  dba Cartersville Medical Center

  • General Acute Care Hospital
  • Cartersville, GA
  • NPI 1780638833

  O20040304000831

  Same enrollment
• Select Specialty Hospital Midtown Atlanta LLC

  • Long Term Care Hospital
  • Atlanta, GA
  • NPI 1235598095

  O20040304000831

  Same enrollment

Locations

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.

• Shannon Fields

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1518031707
  Medicare reassignment NPD

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1114146677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54424",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303080424",
            "telephone_number": "770-458-1594",
            "fax_number": "770-458-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 BLACKLAND CT E",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30067",
            "telephone_number": "404-313-0515",
            "fax_number": "678-540-5473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "960 Joe Frank Harris Pkwy SE",
            "address_purpose": "LOCATION",
            "city": "Cartersville",
            "state": "GA",
            "postal_code": "301202129",
            "country_code": "US",
            "telephone_number": "470-490-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "705 Juniper St NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303081307",
            "country_code": "US",
            "telephone_number": "404-873-2871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN HOSPITAL PHYSICIANS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2025-08-05",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-313-0515"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "047899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000842916G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Southside Medical Center, Inc (Cumberland Pediatrics at Southside Medical Center)

• Internal Medicine Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.