SOUTH REGIONAL SURGICAL SERVICES (NPI# 1679090815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679090815 |
| Entity Type | Organization |
| Organization Name | SOUTH REGIONAL SURGICAL SERVICES |
| Practice Address |
145 Forest Hall Ln Fayetteville GA 30214-4025 |
| Practice Telephone | 6786628792 |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2017-08-28 |
| Authorized Official Name | ANTHONY ROBINSON (PRESIDENT) |
| Authorized Official Telephone | 6786628792 |
| Authorized Official Credential | CSA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302F00000X | Exclusive Provider Organization | Managed Care Organizations |
| Street Address |
145 FOREST HALL LN |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-4025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871692517 | Anthony J Robinson | Specialist/Technologist, Other | 145 Forest Hall Ln, Fayetteville, GA 30214-4025 | 2006-09-21 |
| 1770859563 | Vanessa King | Contractor | 145 Forest Hall Ln, Fayetteville, GA 30214-4025 | 2012-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 302F00000X |
| Grouping | Managed Care Organizations |
| Classification | Exclusive Provider Organization |
| (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 15; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58; (3) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861930802 | Rico's Daycare | Exclusive Provider Organization | 809 Berwick Dr, Fayetteville, NC 28314-0837 | 2017-02-10 |
| 1215341649 | New Beginning of Nc, LLC | Exclusive Provider Organization | 100 Westlake Rd Ste 100, Fayetteville, NC 28314-1660 | 2014-06-13 |
| 1992127518 | The Bliss Center, Paracletos Institute International | Exclusive Provider Organization | 109 N 85 Pkwy, Suite B, Fayetteville, GA 30214-4003 | 2014-01-16 |
| 1619280914 | Ronald S D'amico Dpm | Exclusive Provider Organization | 7000 E Genesee St # D, Fayetteville, NY 13066-1131 | 2010-07-15 |
| 1023204393 | Alternative Life Solutions Inc. | Exclusive Provider Organization | 854 Durwood Dr, Fayetteville, NC 28311-1854 | 2007-09-20 |
| 1356614556 | Brian W Buell Eye Care Pa | Exclusive Provider Organization | 4083 N Shiloh Dr, Suite One, Fayetteville, AR 72703-5300 | 2012-02-17 |
| 1831333723 | United Day Support Services | Exclusive Provider Organization | 535 Bunce Road, Fayetteville, NC 28314-2903 | 2009-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841739984 | Under The Shadows Private Home Care | Exclusive Provider Organization | 208 Curtis Street, Sylvania, GA 30467 | 2017-02-22 |
| 1851830806 | Martinez Orthodontics, PC | Exclusive Provider Organization | 4469 Columbia Rd Ste B, Martinez, GA 30907-4573 | 2017-02-22 |
| 1467900191 | The 831 Company | Exclusive Provider Organization | 788 Hightower Rd, Macon, GA 31206-2240 | 2016-09-11 |
| 1992151567 | Cindys Childrens Charitable & Elderly Care Foundation Inc. | Exclusive Provider Organization | 1249 Kasandra Dr Se, Marietta, GA 30067-7713 | 2016-05-12 |
| 1275925711 | Briah Fashions LLC | Exclusive Provider Organization | 1215 Lionsgate Dr, Conyers, GA 30094-6106 | 2015-02-20 |
| 1992105258 | My Matrix, Incorporated | Exclusive Provider Organization | 2640 Martin Luther King Jr Dr Sw, Atlanta, GA 30311-6101 | 2014-08-23 |
| 1356760318 | Specialized Therapy Solutions, LLC | Exclusive Provider Organization | 1494 Hampton View Ct, Marietta, GA 30008-4094 | 2014-04-07 |
| 1558787085 | Qura Woodbury | Exclusive Provider Organization | 464 Vinings Vintage Cir, Mableton, GA 30126-7207 | 2014-03-07 |
| 1285059006 | Brandy Schultz Cares | Exclusive Provider Organization | 1960 Morning Ln Nw, Acworth, GA 30102-7912 | 2014-03-03 |
| 1740604883 | Judin Lynch | Exclusive Provider Organization | 919 Koala Ct, Lawrenceville, GA 30043-7699 | 2014-02-10 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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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.