Joseph Daniel Souders, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8415 Issued in GA

Practice address

3301 N Oak Street Ext
Valdosta, GA 31605-1014

Phone

(229) 242-6061

Fax

(229) 242-6151

NPI assigned

Jul 18, 2017

Last updated

Dec 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brian C. Griner, MD, LLCGroup PAC ID 8921190901, 4 clinicians

SGMC Affiliated Services LLCGroup PAC ID 5496284028, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SGMC Affiliated Services LLC

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1114740362
  Medicare reassignment Care Compare group NPD
• Brian C. Griner, MD, LLC

  dba Griner Medical Group

  • Pediatrics Physician
  • Valdosta, GA
  • NPI 1083832901
  Medicare reassignment Care Compare group
• South Georgia Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Thomasville, GA
  • NPI 1386903649
  Medicare reassignment
• Radiology Associates of Valdosta, P.C.

  • Diagnostic Radiology Physician
  • Valdosta, GA
  • NPI 1205888708
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Georgia Medical Center Inc

  dba SGMC Health

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Care Compare affiliation

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1316460736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 N OAK STREET EXT",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31605",
            "telephone_number": "229-242-6061",
            "fax_number": "229-242-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 N OAK STREET EXT",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316051014",
            "telephone_number": "229-242-6061",
            "fax_number": "229-242-6151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 N Patterson St",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316021735",
            "country_code": "US",
            "telephone_number": "229-433-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUDERS",
        "first_name": "JOSEPH",
        "middle_name": "DANIEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-18",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003193212A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Solstas Lab Partners Group LLC
• Katherine M Sommer, RD
• Sharmila Sookram-Julian, RN
• Austin W Sorchik, DO
• Ashley Craig Sorrell
• South Albany Pharmacy (U Save It Pharmacy - Valdosta)
• South Albany Pharmacy, LLC (u save it pharmacy valdosta LTC)
• South Central Primary Care Center, Inc
• South Central Primary Care Center, Inc (Valdosta Children's Healthcare)
• South Central Primary Care Center, Inc (Valdosta Internal Medicine)

• Physician Assistant in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.