The Endoscopy Center of Southeast Georgia, Inc

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

138082 Issued in GA

Legal business name

THE ENDOSCOPY CENTER OF SOUTHEAST GEORGIA, INC

Practice address

200 Maple Dr
Vidalia, GA 30474-8907

Phone

(912) 538-1003

Fax

(912) 537-9843

NPI assigned

Jun 28, 2005

Last updated

Jan 29, 2014By 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

Mrs. Dixie Louise Calhoun, BSN

Title

Administrator

Phone

(912) 538-1003

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

The Endoscopy Center of Southeast Georgia IncCCN 11C0001056

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 6

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.

• Robert Lee Arnold, MPAS, PA-C

  • Medical Physician Assistant
  • Vidalia, GA
  • NPI 1265426639
  NPD (past)
• James H Barber Jr., M. D.

  • Internal Medicine Physician
  • Vidalia, GA
  • NPI 1982698346
  NPD (past)
• Dustin J Carter, MPAS, PA-C

  • Medical Physician Assistant
  • Vidalia, GA
  • NPI 1982698361
  NPD (past)
• Joseph Blaise Claroni, P.A.

  • Physician Assistant
  • Dublin, GA
  • NPI 1669438834
  NPD (past)
• Ronnie R Smith, M. D.

  • Internal Medicine Physician
  • Vidalia, GA
  • NPI 1669465670
  NPD (past)
• Megan Mosley Deal, MSN, FNP-BC

  • Nurse Practitioner
  • Minnetonka, MN
  • NPI 1609397082
  NPD (past)

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390953600000",
    "number": "1265439830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748907",
            "telephone_number": "912-538-1003",
            "fax_number": "912-537-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748907",
            "telephone_number": "912-538-1003",
            "fax_number": "912-537-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ENDOSCOPY CENTER OF SOUTHEAST GEORGIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2014-01-29",
        "status": "A",
        "authorized_official_last_name": "CALHOUN",
        "authorized_official_first_name": "DIXIE",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "912-538-1003",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "GA",
            "license": "138082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000590147A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sweet Onion Pharmacy
• John Holmes Talton, DDS
• Tattnall Hospital Company, LLC (Optim Health System ENT)
• Lillian Taylor
• The Baxley & Appling County Hospital Authority (Appling Healthcare Group of Vidalia)
• The Neurological Institute of Savannah & Center for Spine, PC
• The Oaks - Bethany Assisted Living, LLC (The Oaks - Bethany Assisted Living)
• The Oaks - Bethany Skilled Nursing, LLC (The Oaks - Bethany Skilled Nursing)
• Thomas M. Allen M.D., LLC
• Pam McIntyre Or Lou Thompson, RD LD RDN LDN

• Endoscopy Clinic/Center in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Endoscopy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.