Active NPI
Southern Crescent Physicians Group, Inc.
- Surgery Physician
- Jonesboro, GA
National Provider Identifier
1174923478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 072683
- Legal business name
- SOUTHERN CRESCENT PHYSICIANS GROUP, INC.
- Practice address
- 7813 Spivey Station Blvd
Suite 100
Jonesboro, GA 30236-2900 - Phone
- (770) 996-3190
- NPI assigned
- Aug 25, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John McClain
- Title
- Ceo
- Phone
- (770) 897-7056
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 016401 | GA | |
| Neurology Physician | 2084N0400X | 053450 | GA | |
| Surgery Physician | 208600000X | 072683 | GA | Primary |
Addresses
Primary practice location
7813 Spivey Station Blvd
Suite 100
Jonesboro, GA 30236-2900
Mailing address
11 Upper Riverdale Rd SW
Riverdale, GA 30274-2615
Phone (770) 897-7056
National Provider Directory
National Provider Directory- Tax ID family
- Southern Crescent Physicians Group
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Surgery Physician
- Riverdale, GA
- NPI 1366841082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408924800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1408924800000",
"number": "1174923478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 UPPER RIVERDALE RD SW",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302742615",
"telephone_number": "770-897-7056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7813 SPIVEY STATION BLVD",
"address_2": "SUITE 100",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302362900",
"telephone_number": "770-996-3190"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN CRESCENT PHYSICIANS GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2014-08-25",
"last_updated": "2014-08-25",
"status": "A",
"authorized_official_last_name": "MCCLAIN",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "770-897-7056"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "GA",
"license": "016401",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": "GA",
"license": "053450",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": "GA",
"license": "072683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, GA
- Rajiv Sood, D.O.
- Sound & Stable Mind Inc.
- South Atlanta Primary Care PC
- Southern Crescent Home Care
- Southern Crescent Medical Clinic, Inc.
- Southern Crescent Physicians Group, Inc.
- Southern Crescent Primary Care
- Southern Creseant Surgical Assistants
- Southlake Ambulatory Surgery Center, LLLP
- Southmetro Chiropractic Center, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.