Southeastern Surgical Center

Primary specialty

Ambulatory Fertility FacilityTaxonomy code 261QA0006X

Legal business name

SOUTHEASTERN SURGICAL CENTER

Practice address

1100 Johnson Ferry Road
Suite 200
Atlanta, GA 30342

Phone

(404) 257-1900

Fax

(404) 257-0792

NPI assigned

Dec 4, 2006

Last updated

Aug 3, 2011By 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

Mr. H Ron H Davidson

Title

Executive Administrator

Phone

(404) 459-3473

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1144388174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY ROAD",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-257-1900",
            "fax_number": "404-257-0792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY ROAD",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-257-1900",
            "fax_number": "404-257-0792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "H RON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "404-459-3473",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0006X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Fertility Facility",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERMIT",
            "identifier": "060079",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeastern Medical Brokers, Inc. (Integrity Medical)
• Southeastern Pain Ambulatory Surgery Center
• Southeastern Pain Specialists, P.C. (Southeastern Pain Specilists)
• Southeastern Radiology Assoc LLC
• Southeastern Rheumatology Alliance (Arthritis & Rheumatology of Georgia)
• Southeastrans Net, LLC
• Southern Bone & Joint Ambulatory Surgical Center, LLC
• Southern Crescent Physicians Group, Inc
• Southern Eye Associates of Ga LLC
• Southern Eye Specialists, P.C.

• Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.