Southern Crescent Hospital for Specialty Care, Inc.

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

License

031-614 Issued in GA

Legal business name

SOUTHERN CRESCENT HOSPITAL FOR SPECIALTY CARE, INC.

Doing business as

Southern Crescent Hospital for Specialty Care

Practice address

11 Upper Riverdale Rd SW
6TH Floor
Riverdale, GA 30274-2615

Phone

(770) 897-7603

Fax

(770) 897-7606

NPI assigned

Oct 10, 2006

Last updated

Aug 3, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Karam

Title

President & Ceo

Phone

(713) 277-2771

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Southern Crescent Hospital for Specialty Care Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1235227737. Details of each certification follow.

• CCN 110223 Hospital · Terminated · Name & address match · Details
• CCN 112015 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 110223

Legal name

SOUTHERN CRESCENT HOSP FOR SPECIALTY CARE

Certification status

Terminated Other: provider status change, Jun 30, 2004

Provider type (POS)

Hospital – Short-term

Participating since

Dec 11, 2003

Last certification

Dec 11, 2003

Beds

30

Ownership / control type

Private (not for profit)

Facility address

11 Upper Riverdale Rd SW 6TH Floor
Riverdale, GA 30274

Hospital certification: CCN 112015

Legal name

SOUTHERN CRESCENT HOSPITAL FOR SPECIALTY CARE

Certification status

Terminated Voluntary: merger or closure, Oct 1, 2018

Provider type (POS)

Hospital – Long-term

Participating since

Jul 1, 2004

Last certification

Nov 5, 2015

Beds

30

Ownership / control type

Private (not for profit)

Facility address

11 Upper Riverdale Road SW 6TH Floor
Riverdale, GA 30274

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gena M Abrams-Cardoza, P.T.

  • Physical Therapist
  • Riverdale, GA
  • NPI 1649470105
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1235227737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 UPPER RIVERDALE RD SW",
            "address_2": "6TH FLOOR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742615",
            "telephone_number": "770-897-7603",
            "fax_number": "770-897-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 UPPER RIVERDALE RD SW",
            "address_2": "6TH FLOOR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742615",
            "telephone_number": "770-897-7603",
            "fax_number": "770-897-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CRESCENT HOSPITAL FOR SPECIALTY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "KARAM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "713-277-2771"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "GA",
            "license": "031-614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7361505",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003109426A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PVN",
            "identifier": "3397399",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Crescent Hospital for Specialty Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Atlanta Pulmonary & Critical Care Associates
• South Atlanta Radiology Associates, P.C.
• South Metro Primary Care
• South Metro Primary Care,P.C.
• South Sound Inpatient Physicians, PLLC (Sound Physicians of Georgia)
• Southern Crescent Pediatrics PC
• Southern Crescent Physicians Group
• Southern Crescent Physicians Group, Inc
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Physicians Group, Inc.

• Long Term Care Hospital in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Long Term Care Hospital in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.