Southeast Regional Cardiac and Vascular Institute, LLC

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

65260 Issued in GA

Legal business name

SOUTHEAST REGIONAL CARDIAC AND VASCULAR INSTITUTE, LLC

Practice address

101 Harris Industrial Blvd
Suite a
Vidalia, GA 30474-8852

Phone

(912) 535-3500

Fax

(912) 535-4498

NPI assigned

Mar 9, 2010

Last updated

Nov 4, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHEAST REGIONAL PRIMARY CARE CORPORATIONAs reported in NPPES

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

Authorized official

Name

Tony M Osteen

Title

Cfo

Phone

(912) 537-5314

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Southeast Regional Primary Care Corporation

Locations

Interoperability endpoints

• Direct secure messaging: martha.smith@srcvi.gadirect.net
• Direct secure messaging: heather.elliott@srcvi.gadirect.net
• Direct secure messaging: john.higgins@srcvi.gadirect.net
• Direct secure messaging: kenneth.marvin@srcvi.gadirect.net
• Direct secure messaging: cindy.holton@srcvi.gadirect.net
• Direct secure messaging: candice.barfield@srcvi.gadirect.net

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.

• Candace Barfield

  • Contractor
  • Lawrenceville, GA
  • NPI 1760757496
  NPD
• Heather Castleberry, M.D.

  • Family Medicine Physician
  • Daphne, AL
  • NPI 1770994618
  NPD

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1740503440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750407",
            "telephone_number": "912-535-3500",
            "fax_number": "912-535-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD",
            "address_2": "SUITE A",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748852",
            "telephone_number": "912-535-3500",
            "fax_number": "912-535-4498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Cross St",
            "address_purpose": "LOCATION",
            "city": "Hazlehurst",
            "state": "GA",
            "postal_code": "315396427",
            "country_code": "US",
            "telephone_number": "912-535-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "195 E Tollison St Ste A-B",
            "address_purpose": "LOCATION",
            "city": "Baxley",
            "state": "GA",
            "postal_code": "315130172",
            "country_code": "US",
            "telephone_number": "912-535-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEAST REGIONAL CARDIAC AND VASCULAR INSTITUTE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST REGIONAL PRIMARY CARE CORPORATION",
        "enumeration_date": "2010-03-09",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "OSTEEN",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-537-5314"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "65260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "489617065A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Tashina Smith, LPC
• South Georgia Pulmonary, Critical Care and Sleep Medicine
• Southeast Chiropractic Clinic LLC
• Southeast Ga Primary Prevent
• Southeast Lung & Critical Care Specialists, PC (Southeast Lung Associates)
• Southeast Regional Kidney and Hypertension Specialists, LL
• Southeast Regional Primary Care Corporation (Meadows Medical Group Urology)
• Southeast Regional Primary Care Corporation (Meadows Medical Group Internal Medicine)
• Southeast Regional Primary Care Corporation (Meadows Medical Group General and Vascular Surgery)
• Southeast Regional Primary Care Corporation (Meadows Medical Group ENT)

• Interventional Cardiology Physician in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Interventional Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.