Southeastern Orthopaedics Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTHEASTERN ORTHOPAEDICS SURGERY CENTER

Practice address

110 Shirley Avenue
Douglas, GA 31533-2211

Phone

(912) 383-9789

Fax

(912) 383-9435

NPI assigned

Feb 18, 2013

Organization subpart

No

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

Authorized official

Name

Kendra Streat

Title

Administrator

Phone

(912) 383-9789

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Southeastern Orthopaedics Surgery CenterCCN 11C0001428

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1326388000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SHIRLEY AVENUE",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332211",
            "telephone_number": "912-383-9789",
            "fax_number": "912-383-9435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SHIRLEY AVENUE",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332211",
            "telephone_number": "912-383-9789",
            "fax_number": "912-383-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN ORTHOPAEDICS SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-18",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "STREAT",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "912-383-9789"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Georgia Therapy Center
• Southcare of Douglas, Inc
• Southeast Lung & Critical Care Specialists
• Southeastern Home Health Inc
• Southeastern Neuromuscular Massage Therapy, Inc.
• Southeastern Orthopedics
• Southeastern Orthopedics
• Southern Chiropractic of Douglas, Inc.
• Southern Coastal Premier Chiropractic PC
• Southern Community Services Inc

• Ambulatory Surgical Clinic/Center in Douglas, GA
• Providers in Douglas, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

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