Southland - Lakeland Medical Services, LLC
Organization Active NPI General Acute Care Hospital · Lakeland, GA
NPI 1821341397 · NPPES record last updated Apr 24, 2024
Key facts
- NPI
- 1821341397
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- Legal business name
- SOUTHLAND - LAKELAND MEDICAL SERVICES, LLC
- Practice address
- 116 W Thigpen Ave
Lakeland, GA 31635-1011 - Phone
- (229) 236-0831
- NPI assigned
- Oct 22, 2012
- Organization subpart
- No
Authorized official
- Name
- Stephanie Fletcher
- Title
- Cfo
- Phone
- (229) 236-0831
Practitioners 25
-
Bobby Joe Guess Jr., FNP-C
-
Mesheal L Leverett, NP-C
-
Robina W Belanger, FNP
-
Stephen Tracy Mears, ARNP
-
Stamey Seleste Cook, FNP-C
-
Ronald Bruce Herrington, M.D.
-
William David Houston, FNP-C
-
Mark Allen Lee, M.D.
-
Marcie Leann Merritt, N.P.
-
Joshua Paul Stauffer, NURSE PRACTITIONER
-
Catherine Divingian, MD PHD
-
Heather Marie Blackburn, PA-C
-
Willy David Booker, PA-C
-
Keith W Munoz Sr., P.A.-C
-
Treasure F Pope, P.A.-C
-
Hannah Carters Roberts, PA-C
-
Jason Eric Seymour, PA-C
-
Daniel T Kuder, PA-C
-
John Steigner, PA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121219000267 | GA | Part B Supplier - Clinic/Group Practice | 5890947980 |
Receives reassigned benefits from 25 practitioners Practice locations: Lakeland, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Yes | ||
| Critical Access Hospital | 282NC0060X |
Addresses
Primary practice location
116 W Thigpen Ave
Lakeland, GA 31635-1011
Mailing address
PO Box 1276
Thomasville, GA 31799-1276
Phone (229) 977-6692
Other providers in Lakeland, GA
- South Georgia Medical Center Inc
- South Georgia Medical Center Inc
- South Georgia Medical Center Inc
- South Georgia Medical Center Inc
- South Health District
- Kinsey Spivey
- Pamela Tomberlin Stone I
- Kimberly Taylor
- Becky Thompson
- Kaytlin Tucker
All providers in Lakeland, GA · General Acute Care Hospital in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.