SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC (NPI# 1104183268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104183268 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC |
| Other Organization Name | SOUTHEAST LUNG ASSOCIATES |
| Practice Address |
11909 Mcauley Dr Plaza C, Suite A-1 Savannah GA 31419-1793 |
| Mailing Address |
Po Box 14417 Savannah GA 31416-1417 |
| Practice Telephone | 9129276270 |
| Practice Fax Number | 9129276254 |
| Mailing Telephone | 9126292290 |
| Mailing Fax Number | 9126292291 |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2014-04-30 |
| Authorized Official Name | APRIL YOUNG (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 9126290457 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000914922A | 05 | |
| GA | 487007710A | 05 | |
| GA | 696088793A | 05 | |
| GA | 000148519A | 05 | |
| GA | 000526336A | 05 | |
| GA | 000788818G | 05 |
| Other Name | Type Code |
|---|---|
| Southeast Lung Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770989154 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 800 East 68th Street, Landmark Hospital, Savannah, GA 31405 | 2014-11-12 |
| 1457776916 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 201 N River St, Claxton, GA 30417-1658 | 2014-02-20 |
| 1790020444 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 215 Sheraton Blvd, Suite 2, Macon, GA 31210-1359 | 2012-12-06 |
| 1164789251 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 8 Okatie Center Blvd S, Suite 101, Bluffton, SC 29909-7532 | 2012-04-13 |
| 1104346394 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 7 Rosewood Ave, Tybee Island, GA 31328-9435 | 2017-06-20 |
| 1235591652 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 105 Grand Central Blvd, Suite 108, Pooler, GA 31322-4148 | 2016-03-24 |
| 1447628789 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 370 Peachtree St, Jesup, GA 31545-0244 | 2015-09-03 |
| 1972901395 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 5354 Reynolds St, Suite #318, Savannah, GA 31405-6007 | 2014-12-17 |
| 1588060446 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 166 Memorial Dr, Jesup, GA 31545-0101 | 2014-11-05 |
| 1922402122 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 230 Memorial Dr, Jesup, GA 31545-0102 | 2014-10-16 |
| Street Address |
11909 MCAULEY DR PLAZA C, SUITE A-1 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31419-1793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245389642 | Mark Anthony Winchell | Orthopaedic Surgery | 11909 Mcauley Dr, Suite 100 A2, Savannah, GA 31419-1793 | 2007-01-09 |
| 1558535435 | Hope Lyon | Massage Therapist | 11909 Mcauley Dr, Suite 100 A2, Savannah, GA 31419-1793 | 2008-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932653 | Loving Hands Adult Care | Home Health Aide | 101 St. Goerge Blvd, 6t, Savannah, GA 31419 | 2020-11-03 |
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1699318139 | Jessica Kaitlyn Matthewson | Nurse Practitioner | 11700 Mercy Blvd Plaza D, Bldg #5, Savannah, GA 31419 | 2019-10-28 |
| 1679133219 | Rebecca Denise Brown-tuyishimire | Counselor | Savannah Outpatient Clinic, 1170 Shawnee Street, Savannah, GA 31419 | 2019-06-17 |
| 1356900856 | Julio Roberto Castellanos Jr. | Behavior Technician | 785 King George Blvd Ste 103, Savannah, GA 31419 | 2019-06-07 |
| 1669941761 | Paul-david Arthur Cooper | Peer Specialist | 117 Shawnee Street, Va Savannah Clinic, Savannah, GA 31419 | 2018-11-19 |
| 1326538521 | Jay Carter Jr. | Social Worker | 1170 Shawnee St., Savannah, GA 31419 | 2018-05-14 |
| 1245771070 | Emily Robertson | Nurse Practitioner | 11133 Abercorm Street, Suite 10, Savannah, GA 31419 | 2017-03-13 |
| 1760833750 | Cady-jo Steidle | Behavioral Analyst | 143 Sugar Mill Cir, Savannah, GA 31419 | 2016-06-30 |
| 1265881189 | Mallory Williams | Physician Assistant | 11909 D. Mcauley Drive, Savannah, GA 31419 | 2016-06-10 |
| Find all providers in zip 31419 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235659814 | Southeast Lung & Criticial Care Specialists, PC | Internal Medicine | 5356 Reynolds St Ste 303, Savannah, GA 31405-6018 | 2017-06-23 |
| 1770989154 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 800 East 68th Street, Landmark Hospital, Savannah, GA 31405 | 2014-11-12 |
| 1174780472 | Robert James Dibenedetto | Internal Medicine | 8 Cedar Marsh Retreat, Savannah, GA 31411-2922 | 2008-05-22 |
| 1255489019 | Masood Ahmed | Internal Medicine | 5356 Reynolds Street, Suite 303, Savannah, GA 31405-6016 | 2007-01-08 |
| 1982769568 | Savannah Medical Specialists PC | Internal Medicine | 5354 Reynolds St Ste 505, Savannah, GA 31405-6012 | 2006-12-26 |
| 1689672438 | Patricia Ann Costanzo | Internal Medicine | 4 Sea Oats Ln, Savannah, GA 31411-3102 | 2005-07-14 |
| 1972901395 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 5354 Reynolds St, Suite #318, Savannah, GA 31405-6007 | 2014-12-17 |
| 1447675905 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 340 Hodgson Ct, Suite #2, Savannah, GA 31406-1520 | 2014-02-20 |
| 1194153874 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 11800 Abercorn St, Savannah, GA 31419-1908 | 2013-10-16 |
| 1205193398 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 11706 Mercy Blvd, Bldg #4, Savannah, GA 31419-1751 | 2012-04-13 |
| Find all providers in SAVANNAH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.