NPIMap

Organization Active NPI

Southeastern Rheumatology Alliance

Doing business as Coastal Rheumatology Associates

  • 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
Doing business as
Coastal Rheumatology Associates
Practice address
110 Rushing LN Ste B
Statesboro, GA 30458-6027
Phone
(912) 210-0276
Fax
(912) 428-7201
NPI assigned
May 20, 2025
Last updated
May 20, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHEASTERN RHEUMATOLOGY ALLIANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X Primary
Non-Pharmacy Dispensing Site 332900000X

Addresses

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

  • COASTAL RHEUMATOLOGY ASSOCIATES Doing business as

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.

Ownership & related parties

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.

NPI Registry JSON

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

{
    "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": "",
            "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.