NPIMap

Organization Active NPI

Southeast Surgical Assistants, LLC

  • Surgical Physician Assistant
  • Evans, GA
National Provider Identifier
1154697357
Registry record updated Apr 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
SOUTHEAST SURGICAL ASSISTANTS, LLC
Practice address
5008 Sussex Dr
Evans, GA 30809-8231
Phone
(706) 650-7788
Fax
(800) 615-6836
NPI assigned
Apr 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2012

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

Authorized official

Name
Mr. Jeffrey PunshonNPI 1508088071
Title
Managing Partner
Phone
(706) 650-7788

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

5008 Sussex Dr
Evans, GA 30809-8231

Mailing address

5008 Sussex Dr
Evans, GA 30809-8231
Phone (706) 650-7788

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1333238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333238400000",
    "number": "1154697357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 SUSSEX DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098231",
            "telephone_number": "706-650-7788",
            "fax_number": "800-615-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 SUSSEX DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098231",
            "telephone_number": "706-650-7788",
            "fax_number": "800-615-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST SURGICAL ASSISTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-01",
        "last_updated": "2012-04-01",
        "status": "A",
        "authorized_official_last_name": "PUNSHON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "706-650-7788",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2012; 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.