SOUTHERN CRESCENT PHYSICIANS GROUP, INC. (NPI# 1366841082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366841082 |
| Entity Type | Organization |
| Organization Name | SOUTHERN CRESCENT PHYSICIANS GROUP, INC. |
| Practice Address |
33 Upper Riverdale Rd Sw Suite 121 Riverdale GA 30274-2626 |
| Mailing Address |
11 Upper Riverdale Rd Sw Riverdale GA 30274-2615 |
| Practice Telephone | 7708977546 |
| Practice Fax Number | 7709918521 |
| Mailing Telephone | 7708977056 |
| Mailing Fax Number | 7709092169 |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-19 |
| Authorized Official Name | JOHN MCCLAIN (CEO) |
| Authorized Official Telephone | 7708977546 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 072683 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588069900 | Southern Crescent Physicians Group, Inc. | Neurological Surgery | 11 Upper Riverdale Rd Sw, Terrace Level, Riverdale, GA 30274-2615 | 2014-10-28 |
| 1174923478 | Southern Crescent Physicians Group, Inc. | Orthopaedic Surgery | 7813 Spivey Station Blvd, Suite 100, Jonesboro, GA 30236-2900 | 2014-08-25 |
| 1275932998 | Southern Crescent Physicians Group, Inc. | Psychiatry & Neurology | 33 Upper Riverdale Rd Sw, Suite 112, Riverdale, GA 30274-2626 | 2014-08-19 |
| 1568861268 | Southern Crescent Physicians Group, Inc. | Surgery | 325 N Jeff Davis Dr, Fayetteville, GA 30214-1627 | 2014-08-19 |
| 1184023806 | Southern Crescent Physicians Group, Inc. | Surgery | 33 Upper Riverdale Rd Sw, Suite 17, Riverdale, GA 30274-2626 | 2014-08-19 |
| 1861891723 | Southern Crescent Physicians Group, Inc. | Surgery | 7823 Spivey Station Blvd, Suite 300, Jonesboro, GA 30236-2886 | 2014-08-17 |
| Street Address |
33 UPPER RIVERDALE RD SW SUITE 121 |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274-2626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144226135 | Michael Angel Dicristina | Internal Medicine | 33 Upper Riverdale Rd Sw, Suite 21, Riverdale, GA 30274-2626 | 2005-06-23 |
| 1073028536 | Okeh Health Group, LLC | Clinic/Center | 33 Upper Riverdale Rd Sw, 17, Riverdale, GA 30274 | 2017-12-06 |
| 1275932998 | Southern Crescent Physicians Group, Inc. | Psychiatry & Neurology | 33 Upper Riverdale Rd Sw, Suite 112, Riverdale, GA 30274-2626 | 2014-08-19 |
| 1184023806 | Southern Crescent Physicians Group, Inc. | Surgery | 33 Upper Riverdale Rd Sw, Suite 17, Riverdale, GA 30274-2626 | 2014-08-19 |
| 1215341375 | Robin Alverson Inc | Audiologist | 33 Upper Riverdale Rd Sw, Ste 117, Riverdale, GA 30274-2642 | 2014-06-17 |
| 1811240054 | Richard A. Stappenbeck, M.d., P.C. | Psychiatry & Neurology | 33 Upper Riverdale Rd Sw, Suite 111, Riverdale, GA 30274-2626 | 2012-10-25 |
| 1255607628 | Minimally Invasive Neurospine and Pain Institute, PC | Clinic/Center | 33 Upper Riverdale Rd Sw, #25, Riverdale, GA 30274-2626 | 2012-03-29 |
| 1093995334 | Shaneeta Johnson | Surgery | 33 Upper Riverdale Rd Sw, Suite 121, Riverdale, GA 30274-2626 | 2007-11-04 |
| 1831391820 | Robin Pasquale Alverson | Audiologist | 33 Upper Riverdale Rd Sw, Suite 117, Riverdale, GA 30274-2626 | 2007-06-03 |
| 1063614204 | Glenn S Shear Mdpc | Specialist | 33 Upper Riverdale Rd Sw, Suite 114, Riverdale, GA 30274-2626 | 2007-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104189190 | Nidhi Khanna | Surgery | 11 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274-2615 | 2012-06-24 |
| 1922282557 | Felix Pelaez | Surgery | 195 Upper Riverdale Rd Sw, #b, Riverdale, GA 30274-2565 | 2007-12-18 |
| 1568685162 | Aaron Matthew Goldfaden | Surgery | 33 Upper Riverdale Rd, Suite 118, Riverdale, GA 30274 | 2007-04-11 |
| 1124191200 | Gokarnesan Natarajan Md PC | Surgery | 528 Valley Hill Rd Sw, Riverdale, GA 30274-2441 | 2006-11-16 |
| 1396735262 | Alexander Egwuatu J Ukoh | Surgery | 4404 Queensbury Rd, Riverdale, MD 20737-1068 | 2005-10-24 |
| 1043677271 | Southern Regional Physicians Management Group, LLC | Surgery | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2016-01-19 |
| 1831554120 | Felix Pelaez Md | Surgery | 195 Upper Riverdale Rd Sw, Suite B, Riverdale, GA 30274-2518 | 2015-12-31 |
| 1184023806 | Southern Crescent Physicians Group, Inc. | Surgery | 33 Upper Riverdale Rd Sw, Suite 17, Riverdale, GA 30274-2626 | 2014-08-19 |
| 1215220488 | Portia Siwawa | Surgery | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2011-05-22 |
| 1194900068 | Surgical Associates, Chartered | Surgery | 6510 Kenilworth Ave, Suite 2100, Riverdale, MD 20737-1339 | 2008-01-09 |
| Find all providers in RIVERDALE | ||||
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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.