Surf and Sand Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SURF AND SAND PEDIATRICS

Practice address

1111 Glynco Pkwy Ste 31
Brunswick, GA 31525-7930

Phone

(912) 456-3605

Fax

(912) 456-3531

NPI assigned

Sep 27, 2022

Organization subpart

No

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

Authorized official

Name

Debra Berry

Title

Managed Care Director

Phone

(912) 445-4387

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica L Albright, RN BSN IBCLC

  • Lactation Consultant (Registered Nurse)
  • Brunswick, GA
  • NPI 1083326656
  NPD
• Amanda Grounds Joseph, MD

  • Pediatrics Physician
  • Brunswick, GA
  • NPI 1336361187
  NPD
• Caroline Dejarnett Flexer, FNP-BC

  • Family Nurse Practitioner
  • Brunswick, GA
  • NPI 1518513258
  NPD (past)

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1770207482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 GLYNCO PKWY STE 31",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315257930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 GLYNCO PKWY STE 31",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315257930",
            "telephone_number": "912-456-3605",
            "fax_number": "912-456-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURF AND SAND PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "MANAGED CARE DIRECTOR",
        "authorized_official_telephone_number": "912-445-4387"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael James Sullivan, M.D.
• Janna Marie Summerall-Smith, M.D.
• Summit Dermatology & Laser Center, P.C.
• Summit Internal Medicine
• Summit Plastic Surgery
• Surfside Kids Pediatric Dentistry P.C.
• Ralph Wade Swann Jr., MD
• Montana Swanson, DPT
• Patience Tajelleh
• Tamsyn O'Flynn, Aprn

• Pediatrics Physician in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.