Southern Crescent Physicians Group, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

072414 Issued in GA

Legal business name

SOUTHERN CRESCENT PHYSICIANS GROUP, INC.

Practice address

7823 Spivey Station Blvd
Suite 300
Jonesboro, GA 30236-2886

Phone

(770) 268-6000

NPI assigned

Aug 17, 2014

Organization subpart

No

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

Authorized official

Name

John McClain

Title

Ceo

Phone

(770) 897-7056

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1408233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408233600000",
    "number": "1861891723",
    "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": "770-897-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7823 SPIVEY STATION BLVD",
            "address_2": "SUITE 300",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362886",
            "telephone_number": "770-268-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CRESCENT PHYSICIANS GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-17",
        "last_updated": "2014-08-17",
        "status": "A",
        "authorized_official_last_name": "MCCLAIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-897-7056"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "072414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sound & Stable Mind Inc.
• South Atlanta Primary Care PC
• Southern Crescent Home Care
• Southern Crescent Medical Clinic, Inc.
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Primary Care
• Southern Creseant Surgical Assistants
• Southlake Ambulatory Surgery Center, LLLP
• Southmetro Chiropractic Center, Inc
• Southside Medical Center, Inc

• Surgery Physician in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2014; 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.