Southern Crescent Surgical Assisting P C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN096995 Issued in GA

Legal business name

SOUTHERN CRESCENT SURGICAL ASSISTING P C

Practice address

798 Mallery St Apt 2
Saint Simons Island, GA 31522-4021

Phone

(404) 408-8696

NPI assigned

Oct 15, 2010

Organization subpart

No

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

Authorized official

Name

Angela C Barnard, FNP

Title

Ceo

Phone

(404) 408-8696

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561939200000",
    "number": "1316257041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 MALLERY ST APT 2",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315224021",
            "telephone_number": "404-408-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 MALLERY ST APT 2",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315224021",
            "telephone_number": "404-408-8696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1032 Laurel Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "302528421",
            "country_code": "US",
            "telephone_number": "404-408-8696",
            "fax_number": "678-432-8914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN CRESCENT SURGICAL ASSISTING P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2019-07-01",
        "status": "A",
        "authorized_official_last_name": "BARNARD",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-408-8696",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN096995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Paige Slack, MD
• Amauri Smith, PT, DPT
• James Stratton Snow Jr., D.O.
• Southeast Georgia Therapy LLC
• Southeastern Health Services, Inc.
• Southern Spine and Rehab, LLC
• Spencer Spine Specialists LLC (Healthsource of St. Simons Island)
• Ashleigh Dehnea Spencer, D.C.
• St Simons Eye Care, LLC
• St Simons Island Clinic

• Family Nurse Practitioner in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.