Southland Medical Group, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

SOUTHLAND MEDICAL GROUP, LLC

Practice address

35 Hospital Rd
Blairsville, GA 30512-3139

Phone

(229) 236-0831

NPI assigned

May 11, 2020

Last updated

May 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Fletcher

Title

Cfo

Phone

(229) 236-0831

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589155200000",
    "number": "1790307908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1276",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317991276",
            "telephone_number": "229-236-0831",
            "fax_number": "229-236-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 HOSPITAL RD",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123139",
            "telephone_number": "229-236-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-236-0831"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Thomasville",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "35 Hospital Rd",
            "city": "Blairsville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305123139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Gerald Smith, PHARMD
• Megan Christine Smith, DO
• Wendy L Smith, M.D.
• Rebecca Danielle Snider, FNP
• Southeast Eye Group LLC
• Southland Union Emergency Medical Services, LLC
• Kimberly Albury Spade, M.ED., CCC-SLP
• Gwen Sparkman, M.ED. CCC-SLP
• Debra D Spaulding
• Lewis Anthony Stanley, CRNA

• Emergency Medicine Physician in Blairsville, GA
• Providers in Blairsville, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.