South Houston Internal Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

047921 Issued in GA

Legal business name

SOUTH HOUSTON INTERNAL MEDICINE

Practice address

1018 Keith Dr
Suite a
Perry, GA 31069

Phone

(478) 987-7444

Fax

(478) 987-7422

NPI assigned

Aug 31, 2006

Last updated

Feb 11, 2010By 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

Joseph Stephen Lomboy, MD

Title

Owner

Phone

(478) 987-7444

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Joseph Stephen R Lomboy, MD

  • Internal Medicine Physician
  • Perry, GA
  • NPI 1215974100
  Medicare reassignment Care Compare group NPD
• Marietta Pana Olaivar-Lomboy, NP

  • Adult Health Nurse Practitioner
  • Perry, GA
  • NPI 1699786327
  Medicare reassignment Care Compare group NPD
• Teresa S Vickers, NP

  • Gerontology Nurse Practitioner
  • Warner Robins, GA
  • NPI 1275060295
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1619089653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 KEITH DR",
            "address_2": "STE A",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310692947",
            "telephone_number": "478-987-7444",
            "fax_number": "478-987-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 KEITH DR",
            "address_2": "SUITE A",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "31069",
            "telephone_number": "478-987-7444",
            "fax_number": "478-987-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HOUSTON INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "LOMBOY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-987-7444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "047921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Perry, GA
• Providers in Perry, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.