South Regional Surgical Services

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

SOUTH REGIONAL SURGICAL SERVICES

Practice address

145 Forest Hall LN
Fayetteville, GA 30214-4025

Phone

(678) 662-8792

NPI assigned

Aug 28, 2017

Last updated

Aug 28, 2017By 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

Anthony Robinson, CSANPI 1871692517

Title

President

Phone

(678) 662-8792

Specialties & licenses 1

Addresses

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.

• Anthony J Robinson, CSA

  • Surgery Physician
  • Fayetteville, GA
  • NPI 1871692517
  NPD Authorized official

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503878400000",
    "number": "1679090815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 FOREST HALL LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 FOREST HALL LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144025",
            "telephone_number": "678-662-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH REGIONAL SURGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-28",
        "last_updated": "2017-08-28",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-662-8792",
        "authorized_official_credential": "CSA"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Exclusive Provider Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; 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.