Organization Active NPI

Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
National Provider Identifier
1760410385
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
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

Updated by the provider on Jan 14, 2025

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)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
638161388AMedicaidGA
DE6935OtherGAMEDICARE 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, IN13 enrollments

Enrollment records 13

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

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.

View all 2,169

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.

Verify at the official NPI Registry.