NPIMap

Organization Active NPI

Southeast Regional Primary Care Corporation

Doing business as Meadows Medical Group Lung and Sleep

  • Pulmonary Disease Physician
  • Vidalia, GA
National Provider Identifier
1225531197
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
Doing business as
Meadows Medical Group Lung and Sleep
Practice address
1811 Edwina Dr
Vidalia, GA 30474-8963
Phone
(912) 538-8105
NPI assigned
Mar 16, 2018
Last updated
Mar 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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

Authorized official

Name
Tony M O'Steen
Title
Cfo
Phone
(912) 535-5560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

1811 Edwina Dr
Vidalia, GA 30474-8963

Mailing address

PO Box 407
Vidalia, GA 30475-0407
Phone (912) 538-8105

Other names 1

  • Meadows Medical Group Lung and Sleep Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southeast Regional Primary Care Corporation12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521158400000",
    "number": "1225531197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750407",
            "telephone_number": "912-538-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 EDWINA DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748963",
            "telephone_number": "912-538-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST REGIONAL PRIMARY CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A",
        "authorized_official_last_name": "O'STEEN",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-535-5560"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadows Medical Group Lung and Sleep",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.