South East Spone Care & Pain MGMT

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTH EAST SPONE CARE & PAIN MGMT

Practice address

7450 Skidaway Rd
Suite B
Savannah, GA 31406

Phone

(912) 233-6811

Fax

(912) 544-0864

NPI assigned

Apr 4, 2013

Organization subpart

Yes

Parent organization

SOUTEAST SPINE CARE AND PAIN MANAGEMENTAs reported in NPPES

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

Authorized official

Name

Ortelio Bosch, MDNPI 1629046842

Title

Owner

Phone

(912) 233-6811

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Southeast Spine Care and Pain Management

Locations

Practitioners 2

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

• Ortelio Bosch, MD

  • Interventional Pain Medicine Physician
  • Savannah, GA
  • NPI 1629046842
  NPD (past) Authorized official
• Russell K Daniel, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Aiken, SC
  • NPI 1376540260
  NPD (past)

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1194068478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 SKIDAWAY RD",
            "address_2": "SUITE B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31406",
            "telephone_number": "912-233-6811",
            "fax_number": "912-544-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 SKIDAWAY RD",
            "address_2": "SUITE B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31406",
            "telephone_number": "912-233-6811",
            "fax_number": "912-544-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH EAST SPONE CARE & PAIN MGMT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTEAST SPINE CARE AND PAIN MANAGEMENT",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "BOSCH",
        "authorized_official_first_name": "ORTELIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-233-6811",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000966139D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Jean Soucy
• John Christopher Soulakos, DMD
• Soulful Wellness Health Agency LLC
• Aaron M Soutar, PA
• South East Medical Response LLC
• South Georgia ER Services, LLC
• South Georgia Hospitalist Services, LLC
• South Georgia Radiology Associates, LLC
• Jacob A South, GENETIC COUNSELOR
• Southcoast Medical Group P C

• Ambulatory Surgical Clinic/Center in Savannah, GA
• Providers in Savannah, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.