Southeast Lung & Critical Care Specialists
Organization Active NPI Pulmonary Disease Physician · Baxley, GA
NPI 1366064164 · NPPES record last updated May 14, 2020
Key facts
- NPI
- 1366064164
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- Legal business name
- SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS
- Practice address
- 1745 City Circle Rd
Baxley, GA 31513-7059 - Phone
- (912) 927-6270
- Fax
- (912) 927-6254
- NPI assigned
- May 14, 2020
- Organization subpart
- No
Authorized official
- Name
- April Young
- Title
- Administrator
- Phone
- (912) 721-5150
Other NPIs on the same Medicare enrollment 33
Practitioners 35
-
Masood Ahmed, M. D.
-
Lorraine L Byrd, ACNP
-
James A Daly III, MD
-
Beth A Lewis, FNP-C
-
Marian J Marrero, PA-C
-
Maria C Mascolo, MD
-
Anne Mills Mathews, M.D.
-
Ryan Brett Moody, M.D
-
Kaitlin O'Sullivan, AGACNP
-
Michael Paul Perkins, M.D.
-
Mary J Porter, MD
-
Obaid Rehman, MD
-
Sarah Rush, PA
-
Aaron M Soutar, PA
-
Edith Utley, PA
-
Alesha Wilhelm, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040415000176 | GA | Part B Supplier - Clinic/Group Practice | 7618962291 |
Receives reassigned benefits from 29 practitioners 33 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Jesup, GA; Vidalia, GA; Tybee Island, GA; Sylvania, GA; Springfield, GA; Savannah, GA; Hinesville, GA; Brunswick, GA… |
National Provider Directory
Locations
1111 Glynco Pkwy
Ste 410
Brunswick, GA 31525
Phone (912) 262-0611
122 Scranton Connector
Ste 122
Brunswick, GA 31525
Phone (912) 262-0611
1921 Whittlesey Rd
Ste 530
Columbus, GA 31904
215 Sheraton Blvd
Macon, GA 31210
Phone (478) 310-2727
130 Canal St
Ste 601
Pooler, GA 31322
Phone (912) 330-0979
594 S Columbia Ave
Ste 500
Rincon, GA 31326
Phone (912) 826-3927
131 Silverwood Ct
Ste 100
Rincon, GA 31326
Phone (912) 826-3927
5354 Reynolds St
Ste 318
Savannah, GA 31405
Phone (912) 352-4777
1006 Mount Vernon Rd
Vidalia, GA 30474
Phone (912) 537-1221
8 Hospital Ctr
Ste 120
Hilton Head, SC 29926
Phone (843) 815-9296
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician |
207RP1001X | Yes |
Addresses
Primary practice location
1745 City Circle Rd
Baxley, GA 31513-7059
Mailing address
PO Box 14417
Savannah, GA 31416-1417
Phone (912) 721-5167
Other names
- Southeast Lung Associates
Other providers in Baxley, GA
- Joshua Poppell Smith
- Stanley N Smith
- Wanda G. Smith
- South Georgia Chiropractic
- Southeast Lung & Critical Care Specialists
- Southeast Lung & Critical Care Specialists, PC
- Southeast Lung & Critical Care Specialists, PC.
- Southern Family Walk-in
- Southern Healthcare Collaboration, Inc
- Southern Healthcare Consulting, LLC
All providers in Baxley, GA · Pulmonary Disease Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.