Southeastern Surgical Associates, P.C.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SOUTHEASTERN SURGICAL ASSOCIATES, P.C.

Practice address

840 First Colonial Rd
Suite 102
Virginia Beach, VA 23451-6106

Phone

(757) 422-2212

Fax

(757) 422-9177

NPI assigned

Jun 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laurence William Enderson III, M.D.

Title

President

Phone

(757) 422-2212

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Alireza Farpour, M.D.

  • Surgery Physician
  • Chesapeake, VA
  • NPI 1467499376
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598703498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 FIRST COLONIAL RD",
            "address_2": "SUITE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516106",
            "telephone_number": "757-422-2212",
            "fax_number": "757-422-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 FIRST COLONIAL RD",
            "address_2": "SUITE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516106",
            "telephone_number": "757-422-2212",
            "fax_number": "757-422-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENDERSON",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-422-2212",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Lynn Sourbeer, PA-C
• Source One Mobility, Inc
• Laurie Angela Southard
• Southeast Industries, Inc
• Southeast Virginia Psychiatry PLLC
• Southern Made Home Care
• Southern Surgical Associates PLLC
• Southern Surgical Associates, LLC (dba AHMED A RAHMAN)
• Fredrick Newell Southern, M.D.
• Karen Southers

• Surgery Physician in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.