SOUTHERN COASTAL ENT PC (NPI# 1104905405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104905405 |
| Entity Type | Organization |
| Organization Name | SOUTHERN COASTAL ENT PC |
| Practice Address |
2500 Starling St Suite 403 Brunswick GA 31520-4265 |
| Practice Telephone | 9122653210 |
| Practice Fax Number | 9122651481 |
| Mailing Telephone | 9122653210 |
| Mailing Fax Number | 9122651481 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2008-07-15 |
| Authorized Official Name | DR. SHERMAN A STEVENSON (OWNER) |
| Authorized Official Telephone | 9122653210 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 057327 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 078903405A | 05 |
| Street Address |
2500 STARLING ST SUITE 403 |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31520-4265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851387310 | Coleman David Sudduth Jr. | Internal Medicine | 2500 Starling St, Suite 504, Brunswick, GA 31520-4265 | 2005-09-21 |
| 1811401854 | Sarah Renee Mobbs | Registered Nurse | 2500 Starling St, Brunswick, GA 31520 | 2017-11-29 |
| 1366987844 | Kristin Stenzel Orendorf | Nurse Practitioner | 2500 Starling St, Suite 501, Brunswick, GA 31520-4265 | 2016-12-20 |
| 1124576616 | Julie Small | Nurse Practitioner | 2500 Starling St, Suite 107, Brunswick, GA 31520-4265 | 2016-09-14 |
| 1083083547 | Laura Winkelman | Nurse Practitioner | 2500 Starling St, Suite 601, Brunswick, GA 31520-4265 | 2015-09-15 |
| 1215305305 | Ahmed Elsharkawi, Md LLC | Internal Medicine | 2500 Starling St, Suite 601, Brunswick, GA 31520-4265 | 2015-09-08 |
| 1619344223 | Elizabeth Blair Coleman | Physician Assistant | 2500 Starling St, Ste 403, Brunswick, GA 31520-4265 | 2015-08-31 |
| 1982967709 | Genesis Dme, Inc. | Durable Medical Equipment & Medical Supplies | 2500 Starling St, Suite 105 Seghs, Brunswick, GA 31520-4265 | 2012-06-18 |
| 1801166749 | Marion E Alston | Nurse Practitioner | 2500 Starling St, Suite 503, Brunswick, GA 31520-4265 | 2012-01-10 |
| 1376853507 | John F. Ellenberg, M.d., P.C. | Obstetrics & Gynecology | 2500 Starling St, 406, Brunswick, GA 31520-4265 | 2010-10-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760953434 | David S Deuser Md & Associates PC | Psychiatry & Neurology | 7 Saint Andrews Court, Brunswick, GA 31520 | 2018-12-06 |
| 1063961845 | Irene Limon | Licensed Practical Nurse | 2009 Ellis Street, Brunswick, GA 31520 | 2016-09-22 |
| 1770936551 | Elaine Latimer-tandy | Counselor | 1801 Gloucester St Ste E, Brunswick, GA 31520 | 2016-07-18 |
| 1710336326 | Giva, Inc. | Home Health | 8 St Andrews Court, Brunswick, GA 31520 | 2016-06-06 |
| 1447618525 | Parmelee Eye Care LLC | Point of Service | 1909 Gloucester St, Brunswick, GA 31520 | 2016-02-04 |
| 1578947800 | Holly Diskin Kinsey | Nurse Practitioner | 3400 Parkwood Drive, Brunswick, GA 31520 | 2015-07-16 |
| 1679976419 | Miriam Hosey | Registered Nurse | 2747 Fourth Street, Glynn County Health Dept., Brunswick, GA 31520 | 2014-10-08 |
| 1558779348 | Tracey Renee Price | Internal Medicine | 3025 Shrine Rd Ste 290, Brunswick, GA 31520 | 2014-07-24 |
| 1770901951 | Candace Shepherd | Social Worker | 707 F Street, Brunswick, GA 31520 | 2014-04-03 |
| 1699193599 | Enrique Martinez, M.d., P.C. | Internal Medicine | 3114 A Shrine Road, Brunswick, GA 31520 | 2014-03-29 |
| Find all providers in zip 31520 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114346251 | Shane Griffith | Otolaryngology | 81 Medical Center Dr Ste 1150, Brunswick, ME 04011-2765 | 2014-04-15 |
| 1811028558 | Coastal Head & Neck Associates, PC | Otolaryngology | 1107 Gloucester St, Brunswick, GA 31520-7053 | 2007-03-07 |
| 1992805253 | Peter D O'connor | Otolaryngology | 331 Maine St Ste 4, Brunswick, ME 04011-3359 | 2006-09-25 |
| 1316935000 | Sherman Aurthur Stevenson | Otolaryngology | 3205 Shrine Road, Suite 480, Brunswick, GA 31520-4722 | 2005-10-07 |
| 1518026053 | Gregory Penner, Md | Otolaryngology | 331 Maine St, Suite 4, Brunswick, ME 04011-3358 | 2006-12-08 |
| 1326159120 | Karla K. Hansen | Otolaryngology | 2500 Starling Street, Suite 601, Brunswick, GA 31520-4271 | 2006-08-31 |
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|---|---|---|---|---|
| 1801402714 | Top Dog Solutions LLC | Otolaryngology | 4295 Interstate Dr Ste B, Macon, GA 31210-6815 | 2020-09-17 |
| 1164076600 | Oglethorpe Ear, Nose & Throat, LLC | Otolaryngology | 219 West Boggs Street, Lexington, GA 30648 | 2019-08-01 |
| 1154822971 | Coastal Ear, Nose & Throat | Otolaryngology | 200 Blue Moon Xing Ste 103, Pooler, GA 31322-9698 | 2018-02-27 |
| 1376928069 | Wiley A. Parker M.d PC | Otolaryngology | 5669 Peachtree Dunwoody Ste 295, Atlanta, GA 30342-1719 | 2015-07-23 |
| 1871970210 | North Atlanta Ear Nose & Throat PC | Otolaryngology | 4150 Deputy Bill Cantrell Memorial Dr., Suite 260, Cumming, GA 30040 | 2015-05-06 |
| 1235516741 | Alicia Bernstein | Otolaryngology | 3400c Old Milton Pkwy Ste 365, Alpharetta, GA 30005-4438 | 2015-05-04 |
| 1730576638 | Mark Arnold | Otolaryngology | 550 Peachtree St Ne Ste 1135550, Atlanta, GA 30308-2247 | 2015-04-20 |
| 1851789580 | William Lawrence Nicholson | Otolaryngology | 360 W 37th St, Sea Island, GA 31561-9748 | 2015-01-05 |
| 1528473881 | Nnenna Ezeilo | Otolaryngology | 619 S 8th St Ste 304, Griffin, GA 30224 | 2014-06-25 |
| 1922413343 | Colin Wyatt Fuller | Otolaryngology | 1120 Fifteenth St, Bp-4109, Augusta, GA 30912 | 2014-06-24 |
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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.