Organization Active NPI

Southern Surgery Center LLC

  • Anesthesiology Physician
  • Lagrange, GA
National Provider Identifier
1639326994
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SOUTHERN SURGERY CENTER LLC
Practice address
1805 Vernon Rd
Suite C
Lagrange, GA 30240-3871
Phone
(706) 812-9902
Fax
(706) 812-0802
NPI assigned
Aug 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Authorized official

Name
Mrs. Pat Thompson
Title
Bom
Phone
(706) 812-9902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1805 Vernon Rd
Suite C
Lagrange, GA 30240-3871

Mailing address

1805 Vernon Rd
Suite C
Lagrange, GA 30240-3871
Phone (706) 812-9902

Other names 1

  • SOUTHERN SURGERY CENTER ANESTHESIA GROUP Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1639326994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 VERNON RD",
            "address_2": "SUITE C",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403871",
            "telephone_number": "706-812-9902",
            "fax_number": "706-812-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 VERNON RD",
            "address_2": "SUITE C",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403871",
            "telephone_number": "706-812-9902",
            "fax_number": "706-812-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "BOM",
        "authorized_official_telephone_number": "706-812-9902",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN SURGERY CENTER ANESTHESIA GROUP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.