NPIMap

Organization Active NPI

Southeastern Rheumatology Alliance

  • Rheumatology Physician
  • Statesboro, GA
National Provider Identifier
1497547178
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
SOUTHEASTERN RHEUMATOLOGY ALLIANCE
Practice address
110 Rushing LN Ste B
Statesboro, GA 30458-6027
Phone
(912) 210-0276
Fax
(912) 428-7201
NPI assigned
May 20, 2025
Organization subpart
Yes
Parent organization
SOUTHEASTERN RHEUMATOLOGY ALLIANCEAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Michael Cullen
Title
Cio
Phone
(770) 714-7857

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Rheumatology Alliance7 organizations share this tax ID, including this one
Part of
Southeastern Rheumatology Alliance

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X Primary
Non-Pharmacy Dispensing Site 332900000X

Addresses

NPPES NPI Registry

Primary practice location

110 Rushing LN Ste B
Statesboro, GA 30458-6027

Mailing address

700 S Enota Dr NE
Gainesville, GA 30501-2403

Other names 1

NPPES NPI Registry
  • COASTAL RHEUMATOLOGY ASSOCIATES Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 20, 2025.

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1497547178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 RUSHING LN STE B",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304586027",
            "telephone_number": "912-210-0276",
            "fax_number": "912-428-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN RHEUMATOLOGY ALLIANCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEASTERN RHEUMATOLOGY ALLIANCE",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "CULLEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "770-714-7857"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COASTAL RHEUMATOLOGY ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.