South Georgia Health Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOUTH GEORGIA HEALTH GROUP, LLC

Practice address

814 Northwood Park Dr
Valdosta, GA 31602-1398

Phone

(229) 259-0032

Fax

(229) 259-0068

NPI assigned

Nov 18, 2008

Organization subpart

No

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

Authorized official

Name

Douglas Moss, MD

Title

Member

Phone

(229) 259-0032

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Veronica Russ

  • Medical Physician Assistant
  • Douglas, GA
  • NPI 1780320937
  NPD (past)

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1306091376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 NORTHWOOD PARK DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021398",
            "telephone_number": "229-259-0032",
            "fax_number": "229-259-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 NORTHWOOD PARK DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021398",
            "telephone_number": "229-259-0032",
            "fax_number": "229-259-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA HEALTH GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-18",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "229-259-0032",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "789586476A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Georgia Eye Partners, PC
• South Georgia Family Medicine
• South Georgia Health Alliance Dba Hospice of South Georgia
• South Georgia Health Group LLC
• South Georgia Health Group LLC
• South Georgia Medical Associates, PC
• South Georgia Medical Center
• South Georgia Medical Center
• South Georgia Medical Center
• South Georgia Medical Center

• Internal Medicine Physician in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; 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.