South Georgia Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

111252ASCA Issued in GA

Legal business name

SOUTH GEORGIA SURGERY CENTER, LLC

Doing business as

South Georgia Surgery Center

Practice address

306 Isabella Street
Waycross, GA 31501-3636

Phone

(912) 490-7246

Fax

(912) 490-7247

NPI assigned

Aug 31, 2006

Last updated

Apr 8, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Lupi, DO

Title

Owner

Phone

(912) 267-9000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• South Georgia Surgery Center Doing business as

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1952412413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 ISABELLA STREET",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315013636",
            "telephone_number": "912-267-9000",
            "fax_number": "912-267-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 ISABELLA STREET",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315013636",
            "telephone_number": "912-490-7246",
            "fax_number": "912-490-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "LUPI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-267-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "111252ASCA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00188566",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495658553A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Georgia Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tara D Smith, APRN,FNP-C, PMHNP-BC
• South Georgia Endoscopy Center, Inc
• South Georgia Lung Specialists,PC
• South Georgia Physicians Group, LLC
• South Georgia Surgery Center
• Southeast Diagnostics LLC
• Southeast Georgia Anesthesia LLC
• Southeast Georgia Gastroenterology PC
• Southeast Georgia Health Services, L.L.C. (Memorial Satilla Health)
• Southeast Georgia Health Services, L.L.C. (Memorial Satilla Health)

• Ambulatory Surgical Clinic/Center in Waycross, GA
• Providers in Waycross, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.