Active NPI
Hospital Physician Services - Southeast Professional Corporation
- Hospitalist Physician
- Monroe, GA
National Provider Identifier
1760410385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- Legal business name
- HOSPITAL PHYSICIAN SERVICES - SOUTHEAST PROFESSIONAL CORPORATION
- Practice address
- 2151 W Spring St
Monroe, GA 30655-3202 - Phone
- (770) 267-8461
- NPI assigned
- Jun 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tonya Lynn Scanlan
- Title
- Pe Director
- Phone
- (954) 377-2954
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | Primary | ||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
2151 W Spring St
Monroe, GA 30655-3202
Mailing address
1643 NW 136TH Ave Ste 100
Sunrise, FL 33323-2857
Phone (800) 424-3672
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 638161388A | Medicaid | GA | |
| DE6935 | Other | GA | MEDICARE TRAVELERS RR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, SC, NC, AL, FL, LA, TX, OH, TN, VA, NE, OK, IN
Enrollment records 13
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060419000545 | GA | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 827 practitioners Practice locations: Waycross, GA; Thomson, GA; Augusta, GA; Stockbridge, GA; Snellville, GA; Rome, GA; Monroe, GA; Madison, GA… |
| O20100107000067 | SC | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 310 practitioners Practice locations: Florence, SC; Myrtle Beach, SC; Little River, SC; Conway, SC; Belton, SC; Hilton Head Island, SC |
| O20100512000495 | NC | Part B Supplier - Clinic/Group Practice | 5597774554 | Receives reassigned benefits from 579 practitioners |
| O20140219000913 | AL | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 428 practitioners Practice locations: Talladega, AL; Prattville, AL; Montgomery, AL; Chelsea, AL; Brewton, AL; Birmingham, AL; Alabaster, AL; Jasper, AL |
| O20180208000317 | FL | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 124 practitioners Practice locations: Altamonte Springs, FL; Loxahatchee, FL; Saint Petersburg, FL |
| O20181106002747 | LA | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 53 practitioners Practice locations: Zachary, LA |
| O20260102000277 | TX | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 5 practitioners Practice locations: Frisco, TX; Austin, TX; St Paul, TX; Spring, TX; Montgomery, TX |
| O20260106002806 | OH | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 1 practitioner Practice locations: Powell, OH |
| O20260106002834 | TN | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 12 practitioners Practice locations: Hixson, TN; Walland, TN; Murfreesboro, TN; Morristown, TN; Knoxville, TN; Harrison, TN; Franklin, TN; Cleveland, TN… |
| O20260227000013 | VA | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 2 practitioners Practice locations: Virginia Beach, VA; Chesapeake, VA |
| O20260304002706 | NE | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 1 practitioner Practice locations: Elkhorn, NE |
| O20260408003821 | OK | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 1 practitioner Practice locations: Bartlesville, OK |
| O20260522000373 | IN | Part B Supplier - Clinic/Group Practice | 5597774554 |
Receives reassigned benefits from 1 practitioner Practice locations: Zionsville, IN |
National Provider Directory
National Provider DirectoryLocations
428 Biltmore Ave
Ste 4
Asheville, NC 28801
263 S Caldwell St
Brevard, NC 28712
Phone (828) 884-9090
1700 Skylyn Dr
Spartanburg, SC 29307
Phone (864) 573-3123
3429 Regal Dr
Alcoa, TN 37701
Phone (270) 887-0221
Practitioners 2,169
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1736812800000",
"number": "1760410385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1643 NW 136TH AVE STE 100",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232857",
"telephone_number": "800-424-3672",
"fax_number": "954-377-3042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2151 W SPRING ST",
"city": "MONROE",
"state": "GA",
"postal_code": "306553202",
"telephone_number": "770-267-8461"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOSPITAL PHYSICIAN SERVICES - SOUTHEAST PROFESSIONAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-30",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A",
"authorized_official_last_name": "SCANLAN",
"authorized_official_first_name": "TONYA",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "PE DIRECTOR",
"authorized_official_telephone_number": "954-377-2954"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "638161388A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE TRAVELERS RR",
"identifier": "DE6935",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Monroe, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.