NPIMap

Organization Active NPI

Southern Sleep Technologies, Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Macon, GA
National Provider Identifier
1225032261
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
License
02893 Issued in GA
Legal business name
SOUTHERN SLEEP TECHNOLOGIES, INC
Practice address
215 Sheraton Blvd Ste a
Macon, GA 31210-1359
Phone
(478) 757-0759
Fax
(478) 757-0769
NPI assigned
Jun 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
Mr. Mark Shane Mobley, RRT, PSBT
Title
Ceo
Phone
(478) 757-0759

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X 02893 GA Primary

Addresses

Primary practice location

215 Sheraton Blvd Ste a
Macon, GA 31210-1359

Mailing address

215 Sheraton Blvd Ste a
Macon, GA 31210-1359
Phone (478) 757-0759

Other identifiers 2

IdentifierTypeStateIssuer
P00121319OtherGARR MEDICARE
52047683002OtherGABCBS

Other names 1

  • SOUTHERN HOME RESPIRATORY CARE INC Other name

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1225032261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SHERATON BLVD STE A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101359",
            "telephone_number": "478-757-0759",
            "fax_number": "478-757-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SHERATON BLVD STE A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101359",
            "telephone_number": "478-757-0759",
            "fax_number": "478-757-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SLEEP TECHNOLOGIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "MOBLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-757-0759",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RRT, PSBT"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "GA",
            "license": "02893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00121319",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52047683002",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN HOME RESPIRATORY CARE INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.