Southern Crescent Physicians Group, Inc.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

053450 Issued in GA

Legal business name

SOUTHERN CRESCENT PHYSICIANS GROUP, INC.

Practice address

33 Upper Riverdale Rd SW
Suite 112
Riverdale, GA 30274-2626

Phone

(770) 897-7056

Fax

(770) 909-2169

NPI assigned

Aug 19, 2014

Organization subpart

No

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

Authorized official

Name

John McClain

Title

Ceo

Phone

(770) 897-7056

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1275932998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 UPPER RIVERDALE RD SW",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742615",
            "telephone_number": "770-897-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 UPPER RIVERDALE RD SW",
            "address_2": "SUITE 112",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742626",
            "telephone_number": "770-897-7056",
            "fax_number": "770-909-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CRESCENT PHYSICIANS GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "MCCLAIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-897-7056"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "053450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Crescent Hospital for Specialty Care, Inc. (Southern Crescent Hospital for Specialty Care)
• Southern Crescent Pediatrics PC
• Southern Crescent Physicians Group
• Southern Crescent Physicians Group, Inc
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Radiation Oncology Center LLC
• Southern Heart Specialists, P.C.
• Southern Medical Products, Inc.

• Neurology Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Neurology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.