NPIMap

Organization Active NPI

Southeast Lung and Critical Care Specialist

Doing business as Southeast Lung Associates

  • Sleep Disorder Diagnostic Clinic/Center
  • Claxton, GA
National Provider Identifier
1871787069
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
SOUTHEAST LUNG AND CRITICAL CARE SPECIALIST
Doing business as
Southeast Lung Associates
Practice address
405 E Long St
Claxton, GA 30417-1443
Phone
(912) 819-5757
Fax
(912) 819-5753
NPI assigned
Aug 30, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Heather W, Strickland
Title
Finanical Officer
Phone
(912) 927-6270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X GA Primary

Addresses

Primary practice location

405 E Long St
Claxton, GA 30417-1443

Mailing address

340 Hodgson CT
Suite #2
Savannah, GA 31406-1520
Phone (912) 629-2290

Other identifiers 6

IdentifierTypeStateIssuer
000148519LMedicaidGA
000526336AMedicaidGA
487007710AMedicaidGA
696088793AMedicaidGA
000914922AMedicaidGA
000788818LMedicaidGA

Other names 1

  • Southeast Lung Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000176 GA Part B Supplier - Clinic/Group Practice 7618962291 Receives reassigned benefits from 29 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jesup, GA; Vidalia, GA; Tybee Island, GA; Sylvania, GA; Springfield, GA; Savannah, GA; Hinesville, GA; Brunswick, GA…

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1871787069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 HODGSON CT",
            "address_2": "SUITE #2",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061520",
            "telephone_number": "912-629-2290",
            "fax_number": "912-629-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E LONG ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171443",
            "telephone_number": "912-819-5757",
            "fax_number": "912-819-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST LUNG AND CRITICAL CARE SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "STRICKLAND",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "W,",
        "authorized_official_title_or_position": "FINANICAL OFFICER",
        "authorized_official_telephone_number": "912-927-6270"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000148519L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000526336A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "487007710A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "696088793A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000914922A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000788818L",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Lung Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Claxton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.