NPIMap

Organization Active NPI

Southeastern Lung Care PC

  • Pulmonary Disease Physician
  • Conyers, GA
National Provider Identifier
1235114430
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
SOUTHEASTERN LUNG CARE PC
Doing business as
The Sleep Disorders Centers of Southeastern Lung Care
Practice address
1490 Milstead Rd NE Ste a
Conyers, GA 30012-3823
Phone
(770) 922-2217
Fax
(770) 922-1626
NPI assigned
Dec 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Authorized official

Name
Mrs. Andrea Lynn Discordia, BHA CPC CHCC CMM
Title
Ceo Administrator
Phone
(404) 294-4018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

1490 Milstead Rd NE Ste a
Conyers, GA 30012-3823

Mailing address

1490 Milstead Rd NE Ste a
Conyers, GA 30012-3823
Phone (770) 922-2217

Other identifiers 2

IdentifierTypeStateIssuer
55001212AMedicaidGA
400116OtherGABLUE CROSS BLUE SHIELD

Other names 1

  • The Sleep Disorders Centers of Southeastern Lung Care Doing business as

National Provider Directory

National Provider Directory

Locations

1490 Milstead Rd NE
Conyers, GA 30012
Phone (770) 922-2217

1490 Milstead Rd NE
Ste Ab
Conyers, GA 30012

2665 N Decatur Rd
Ste 430
Decatur, GA 30033
Phone (404) 294-4018

320 Winn Way
Ste 103
Decatur, GA 30030

1000 Cowles Clinic Way
Ste D-200
Greensboro, GA 30642
Phone (706) 453-2119

6335 Hospital Pkwy
Ste 307
Johns Creek, GA 30097

5900 Hillandale Dr
Ste F
Lithonia, GA 30058

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70760

Practitioners & affiliated clinicians

Practitioners 7

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": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551830400000",
    "number": "1235114430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 MILSTEAD RD NE STE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123823",
            "telephone_number": "770-922-2217",
            "fax_number": "770-922-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 MILSTEAD RD NE STE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123823",
            "telephone_number": "770-922-2217",
            "fax_number": "770-922-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN LUNG CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2019-03-06",
        "status": "A",
        "authorized_official_last_name": "DISCORDIA",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO ADMINISTRATOR",
        "authorized_official_telephone_number": "404-294-4018",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BHA CPC CHCC CMM"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55001212A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "400116",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Sleep Disorders Centers of Southeastern Lung Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Sleep Disorders Centers of Southeastern Lung Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.