NPIMap

Organization Active NPI

Southeast Lung & Critical Care Specialists,P.C.

Doing business as Southeast Lung Associates

  • Pulmonary Disease Physician
  • Jesup, GA
National Provider Identifier
1770857468
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS,P.C.
Doing business as
Southeast Lung Associates
Practice address
111 Colonial Way
Suite 3
Jesup, GA 31545-0130
Phone
(912) 629-2290
Fax
(912) 629-2291
NPI assigned
Feb 28, 2012
Last updated
Jan 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Authorized official

Name
April Young
Title
Practice Administrator
Phone
(912) 629-0457

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

111 Colonial Way
Suite 3
Jesup, GA 31545-0130

Mailing address

340 Hodgson CT
Suite #2
Savannah, GA 31406-1520
Phone (912) 629-2290

Other identifiers 2

IdentifierTypeStateIssuer
000473833FMedicaidGA
000526336AMedicaidGA

Other names 1

  • Southeast Lung Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southeast Lung Associates40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Locations

111 Colonial Way
Ste 3
Jesup, GA 31545
Phone (912) 427-8365

340 Hodgson Ct
Ste 2
Savannah, GA 31406
Phone (912) 590-5797

NPI Registry JSON

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1770857468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 HODGSON CT",
            "address_2": "SUITE #2",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061520",
            "telephone_number": "912-629-2290",
            "fax_number": "912-629-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLONIAL WAY",
            "address_2": "SUITE 3",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450130",
            "telephone_number": "912-629-2290",
            "fax_number": "912-629-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-28",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "912-629-0457"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000473833F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000526336A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Lung Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.