Southern Podiatry Group, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

SOUTHERN PODIATRY GROUP, PC

Practice address

2718 N Oak St
Valdosta, GA 31602-1781

Phone

(229) 242-3668

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Avis Griffin

Title

Office Manager

Phone

(229) 242-3668

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Valdosta Podiatry Associates, PC Former legal business name

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

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

• Southern Podiatry Group, PC

  • Foot & Ankle Surgery Podiatrist
  • Tifton, GA
  • NPI 1013174457

  O20040507000537

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

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

• Timothy E Pitts, DPM

  • Foot & Ankle Surgery Podiatrist
  • Valdosta, GA
  • NPI 1952361024
  Medicare reassignment NPD
• Hoeung Moeung Chov, DPM

  • Podiatrist
  • Downey, CA
  • NPI 1194826024
  NPD (past)
• David G Cox Jr., D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Lynchburg, VA
  • NPI 1770543852
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1144352956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2718 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021781",
            "telephone_number": "229-242-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PODIATRY GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "AVIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "229-242-3668"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300026567C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300026567A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valdosta Podiatry Associates, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Southern Neurology, Physical Medicine & Rehabilitation, LLC
• Southern OB GYN Ambulatory Surgery Center, Inc
• Southern OB GYN Associates P C
• Southern Orthotics
• Southern Pediatric Clinic, LLC
• Southern Psychological and Behavioral Services, LLC
• Southern Skin & Wellness Center
• Southern Therapy Solutions LLC (Southern Therapy Solutions)
• Southern Urological Associates
• Southland Behavioral Health Services LLC

• Foot & Ankle Surgery Podiatrist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.