Southeastern Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SOUTHEASTERN MEDICAL GROUP, LLC

Doing business as

Madison Family Care

Practice address

1230 Slaughter Rd
Suite C
Madison, AL 35758-5900

Phone

(256) 722-0555

Fax

(256) 830-5135

NPI assigned

Mar 21, 2013

Organization subpart

No

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

Authorized official

Name

Marlee Bruno

Title

Administrator

Phone

(256) 722-0555

Specialties & licenses 1

Addresses

Other names 1

• Madison Family Care Doing business as

Locations

Practitioners 1

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

• Cassie Coulter Ingrum, NP-C

  • Family Nurse Practitioner
  • Athens, AL
  • NPI 1972887123
  NPD (past)

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363824000000",
    "number": "1922340520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 SLAUGHTER RD",
            "address_2": "SUITE C",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585900",
            "telephone_number": "256-722-0555",
            "fax_number": "256-830-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 SLAUGHTER RD",
            "address_2": "SUITE C",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585900",
            "telephone_number": "256-722-0555",
            "fax_number": "256-830-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-03-21",
        "status": "A",
        "authorized_official_last_name": "BRUNO",
        "authorized_official_first_name": "MARLEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "256-722-0555"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela Renee Sommerset, M.D.
• Soothing Shores Counseling, LLC
• Sohrob Sotoudehnia, DMD
• Dajah Souife, CRNP
• Soulcare Medical Consultant LLC
• Southeastern Podiatry LLC
• Southeastern Skin Cancer & Dermatology
• Southern Care Physical Therapy, LLC
• Southern Elevator Service, Inc.
• Southern Family Markets LLC

• Family Medicine Physician in Madison, AL
• Providers in Madison, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.