NPIMap

Organization Active NPI

Southeastern Cardiology Associates PC

  • Interventional Cardiology Physician
  • Columbus, GA
National Provider Identifier
1376527077
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
046075 Issued in GA
Legal business name
SOUTHEASTERN CARDIOLOGY ASSOCIATES PC
Practice address
2121 Warm Springs Rd
Columbus, GA 31904-7955
Phone
(706) 243-4500
Fax
(706) 243-4503
NPI assigned
Dec 6, 2005
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Abby Condra
Title
Credentialing Coordinator
Phone
(706) 243-4506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 046075 GA Primary

Addresses

Primary practice location

2121 Warm Springs Rd
Columbus, GA 31904-7955

Mailing address

PO Box 7067
Columbus, GA 31908-7067
Phone (706) 221-6116

Other practice location 1

2300 Manchester Expy
Bldg H-104
Columbus, GA 31904-6802
Phone (706) 243-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050902000482 GA Part B Supplier - Clinic/Group Practice 0345272910 Receives reassigned benefits from 11 practitioners
Practice locations: Columbus, GA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1043414Southeastern Cardiology Associates PC2121 Warm Springs Road, Columbus, GA 31904Certificate of waiverJul 21, 2027

National Provider Directory

National Provider Directory

Locations

2300 Manchester Expy
Ste H104
Columbus, GA 31904
Phone (706) 243-4500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCCDCA
  • Direct secure messaging: hunter.champion@sec.gadirect.net
  • Direct secure messaging: shane.darrah@sec.gadirect.net
  • Direct secure messaging: sheri.lopez@sec.gadirect.net

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1376527077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7067",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319087067",
            "telephone_number": "706-221-6116",
            "fax_number": "706-221-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 WARM SPRINGS RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319047955",
            "telephone_number": "706-243-4500",
            "fax_number": "706-243-4503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Manchester Expy",
            "address_2": "Bldg H-104",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319046802",
            "country_code": "US",
            "telephone_number": "706-243-4500",
            "fax_number": "706-024-3450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEASTERN CARDIOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "CONDRA",
        "authorized_official_first_name": "ABBY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "706-243-4506"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "046075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.