Southern Crescent Plastic Surgery, PC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

SOUTHERN CRESCENT PLASTIC SURGERY, PC

Practice address

919 Eagles Landing Pkwy
Stockbridge, GA 30281-5011

Phone

(770) 389-0446

Fax

(770) 389-3530

NPI assigned

Sep 21, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Alice Gross, BSN, CNOR, RNFA

Title

Administrator

Phone

(770) 389-0446

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1841573458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815011",
            "telephone_number": "770-389-0446",
            "fax_number": "770-389-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815011",
            "telephone_number": "770-389-0446",
            "fax_number": "770-389-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CRESCENT PLASTIC SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-389-0446",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSN, CNOR, RNFA"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Crescent Medical Center, LLC
• Southern Crescent Nephrology, PC
• Southern Crescent Pain Management LLC
• Southern Crescent Pediatrics PC
• Southern Crescent Plastic Surgery ASC
• Southern Crescent Women'S Health Specialists
• Southern Crescent Womens Health Specialists at Eagle'S Landing
• Southern Medical Clinic LLC
• Southern Medical Clinic, LLC
• Southside Behavioral Health, Inc.

• Plastic and Reconstructive Surgery Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Plastic and Reconstructive Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.