NPIMap

Organization Active NPI

Southern Medical Group, PA

  • Cardiovascular Disease Physician
  • Tallahassee, FL
National Provider Identifier
1417948159
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SOUTHERN MEDICAL GROUP, PA
Practice address
1300 Medical Dr
Tallahassee, FL 32308-4646
Phone
(850) 216-0100
Fax
(850) 216-0180
NPI assigned
Nov 2, 2005
Last updated
Nov 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Authorized official

Name
Kathy Reed
Title
Administrative Credentialing
Phone
(850) 201-4861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

1300 Medical Dr
Tallahassee, FL 32308-4646

Mailing address

1300 Medical Dr
Tallahassee, FL 32308-4646
Phone (850) 216-0100

National Provider Directory

National Provider Directory

Locations

1401 Centerville Rd
Ste 500
Tallahassee, FL 32308
Phone (850) 431-5731

1401 Centerville Rd
Ste 600
Tallahassee, FL 32308
Phone (850) 878-8121

1401 Centerville Rd
Ste 606
Tallahassee, FL 32308

1401 Centerville Rd
Ste 705
Tallahassee, FL 32308

1401 Centerville Rd
Ste 800
Tallahassee, FL 32308
Phone (850) 216-0120

Practitioners & affiliated clinicians

Practitioners 65

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.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1417948159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MEDICAL DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084646",
            "telephone_number": "850-216-0100",
            "fax_number": "850-216-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MEDICAL DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084646",
            "telephone_number": "850-216-0100",
            "fax_number": "850-216-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ADMINISTRATIVE CREDENTIALING",
        "authorized_official_telephone_number": "850-201-4861"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.