Organization Active NPI

Southern Lung Specialists PC

  • Pulmonary Disease Physician
  • Macon, GA
National Provider Identifier
1821440819
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
SOUTHERN LUNG SPECIALISTS PC
Practice address
770 Pine St
Suite 560
Macon, GA 31201-7569
Phone
(478) 745-9998
Fax
(478) 745-9981
NPI assigned
Jul 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Authorized official

Name
Gerald Tarriah
Title
MD
Phone
(478) 745-9998

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

770 Pine St
Suite 560
Macon, GA 31201-7569

Mailing address

770 Pine St
Suite 560
Macon, GA 31201-7569
Phone (478) 745-9998

Other identifiers 1

IdentifierTypeStateIssuer
DW7232OtherGARAILROAD MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160728000017 GA Part B Supplier - Clinic/Group Practice 5395038335 Receives reassigned benefits from 1 practitioner
Practice locations: Macon, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1821440819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 PINE ST",
            "address_2": "SUITE 560",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017569",
            "telephone_number": "478-745-9998",
            "fax_number": "478-745-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE ST",
            "address_2": "SUITE 560",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017569",
            "telephone_number": "478-745-9998",
            "fax_number": "478-745-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN LUNG SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-01",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "TARRIAH",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "478-745-9998"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DW7232",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.