Southern Crescent Physicians Group

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

031442 Issued in GA

Legal business name

SOUTHERN CRESCENT PHYSICIANS GROUP

Practice address

11 Upper Riverdale Rd SW
Riverdale, GA 30274-2615

Phone

(770) 991-8500

Fax

(770) 991-8507

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

John McLain

Title

Coo

Phone

(770) 991-8000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1801979174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 UPPER RIVERDALE RD SW",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742615",
            "telephone_number": "770-991-8500",
            "fax_number": "770-991-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 UPPER RIVERDALE RD SW",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742615",
            "telephone_number": "770-991-8500",
            "fax_number": "770-991-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CRESCENT PHYSICIANS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "MCLAIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-991-8000"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "031442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Metro Primary Care
• South Metro Primary Care,P.C.
• South Sound Inpatient Physicians, PLLC (Sound Physicians of Georgia)
• Southern Crescent Hospital for Specialty Care, Inc. (Southern Crescent Hospital for Specialty Care)
• Southern Crescent Pediatrics PC
• Southern Crescent Physicians Group, Inc
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Physicians Group, Inc.

• Psychiatry Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.