Active NPI
Southern Medical Associates, LLC
- Family Medicine Physician
- Glennville, GA
National Provider Identifier
1356764450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 054519
- Legal business name
- SOUTHERN MEDICAL ASSOCIATES, LLC
- Practice address
- 601 S Veterans Blvd
Glennville, GA 30427-1775 - Phone
- (912) 654-0475
- Fax
- (912) 654-0486
- NPI assigned
- Jan 24, 2014
- Last updated
- Sep 4, 2014
- Organization subpart
- Yes
- Parent organization
- SOUTHEAST REGIONAL PRIMARY CARE CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tony M Osteen
- Title
- Cfo VP Finance
- Phone
- (912) 538-5314
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 054519 | GA | Primary |
Addresses
Primary practice location
601 S Veterans Blvd
Glennville, GA 30427-1775
Mailing address
PO Box 407
Vidalia, GA 30475-0407
Phone (912) 537-4986
National Provider Directory
National Provider Directory- Part of
- Southeast Regional Primary Care Corporation
Interoperability endpoints
- candice.barfield@sma.gadirect.net
- heather.elliott@sma.gadirect.net
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Contractor
- Lawrenceville, GA
- NPI 1760757496
-
- Family Medicine Physician
- Daphne, AL
- NPI 1770994618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390521600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1409788800000",
"number": "1356764450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 407",
"city": "VIDALIA",
"state": "GA",
"postal_code": "304750407",
"telephone_number": "912-537-4986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 S VETERANS BLVD",
"city": "GLENNVILLE",
"state": "GA",
"postal_code": "304271775",
"telephone_number": "912-654-0475",
"fax_number": "912-654-0486"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN MEDICAL ASSOCIATES, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOUTHEAST REGIONAL PRIMARY CARE CORPORATION",
"enumeration_date": "2014-01-24",
"last_updated": "2014-09-04",
"status": "A",
"authorized_official_last_name": "OSTEEN",
"authorized_official_first_name": "TONY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CFO VP FINANCE",
"authorized_official_telephone_number": "912-538-5314"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "054519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glennville, GA
- Daniel Scott Rogers, PHTC
- Shujiao Gui
- Austin Brett Snyder, PHARMD
- South Georgia Therapy Services, P.C. (Kenneth L. Durrence, P.T.)
- Southern Comfort Adult Day Service LLC
- Patrice Stephens
- Stepping Stones Family Wellness Center, LLC
- Strickland's Pharmacy, Inc.
- Shawna Sturges Strub, OD
- Sutton Place (Dylantess Inc)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.