Southern Surgical, PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHERN SURGICAL, PA

Practice address

3600 Sea Mountain Hwy
Suite a
Little River, SC 29566-8161

Phone

(843) 399-9774

Fax

(843) 399-8657

NPI assigned

Oct 25, 2006

Last updated

Jan 25, 2011By 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

Ms. Wilma F Pond

Title

Office Manager

Phone

(843) 399-9774

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

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.

• Robert Louis De Grood, MD

  • Surgery Physician
  • Mullins, SC
  • NPI 1841248085

  Specialist

  NPD (past)
• Trevor Ward Poole, M.D.

  • Specialist
  • Defiance, OH
  • NPI 1891743159
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1699859355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 599",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295690599",
            "telephone_number": "843-399-9774",
            "fax_number": "843-399-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 SEA MOUNTAIN HWY",
            "address_2": "SUITE A",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295668161",
            "telephone_number": "843-399-9774",
            "fax_number": "843-399-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SURGICAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "POND",
        "authorized_official_first_name": "WILMA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-399-9774",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1384",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890625V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Carolina Podiatric Physicians and Surgeons Group, LLC
• South Carolina Podiatric Physicians and Surgeons Group, LLC
• Southern Spinal Care, PC
• Southern Surgical Group, LLC
• Southern Surgical Group, LLC
• Cathy Sparacia
• Olinda P. Spencer, M.D.
• Samantha Electra Spencer
• Sarah Spencer, DDS
• Michael Sperling, M.D.

• Specialist in Little River, SC
• Providers in Little River, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.