SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS (NPI# 1689998536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689998536 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS |
| Practice Address |
209c Mims Rd Sylvania GA 30467-1994 |
| Mailing Address |
340 Eisenhower Dr Building #1500 Savannah GA 31406-1600 |
| Practice Telephone | 9125645977 |
| Practice Fax Number | 9125641259 |
| Mailing Telephone | 9123546614 |
| Mailing Fax Number | 9123569078 |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2010-03-22 |
| Authorized Official Name | MARIA MASCOLO III (PARTNER) |
| Authorized Official Telephone | 9123546614 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
052469 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 487007710A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064164 | Southeast Lung & Critical Care Specialists | Internal Medicine | 1745 City Circle Rd, Baxley, GA 31513-7059 | 2020-05-14 |
| 1164711818 | Southeast Lung & Critical Care Specialists | Internal Medicine | 515 E Winthrope Ave, Millen, GA 30442-1818 | 2011-04-04 |
| 1265755839 | Southeast Lung & Critical Care Specialists | Internal Medicine | 895 S 1st St, Jesup, GA 31545-0210 | 2010-03-10 |
| 1053634618 | Southeast Lung & Critical Care Specialists | Internal Medicine | 340 Eisenhower Dr Ste 1500, Savannah, GA 31406-1603 | 2010-03-10 |
| 1932438850 | Southeast Lung & Critical Care Specialists | Sleep Specialist, PhD | 16741 Fair Rd, Professional Park, G, Statesboro, GA 30458 | 2009-12-24 |
| 1972788081 | Southeast Lung & Critical Care Specialists | Clinic/Center | 447 B. West General Screven Way, Hinesville, GA 31313 | 2008-01-08 |
| 1386914109 | Southeast Lung & Critical Care Specialists | Internal Medicine | 60 Exchange St, Suite B-7, Richmond Hill, GA 31324-7644 | 2012-01-10 |
| 1306142070 | Southeast Lung & Critical Care Specialists | Internal Medicine | 131 Memorial Dr, Reidsville, GA 30453-4641 | 2011-01-28 |
| 1871823187 | Southeast Lung & Critical Care Specialists | Sleep Specialist, PhD | 131 Memorial Dr, Reidsville, GA 30453-4641 | 2010-01-08 |
| 1790015253 | Southeast Lung & Critical Care Specialists | Sleep Specialist, PhD | 200 Doctors Dr, Ste. 112, Douglas, GA 31533-2201 | 2010-01-06 |
| Street Address |
209C MIMS RD |
| City | SYLVANIA |
| State | GA |
| Zip Code | 30467-1994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659884237 | Rachel Oglesby Edenfield | Nurse Practitioner | 1235 Edenfield Road, Sylvania, GA 30467 | 2017-11-06 |
| 1841739984 | Under The Shadows Private Home Care | Exclusive Provider Organization | 208 Curtis Street, Sylvania, GA 30467 | 2017-02-22 |
| 1023357324 | Jenkins County Hospital, LLC | Surgery | 102 Rocky Ford Rd, Sylvania, GA 30467 | 2013-02-06 |
| 1205195476 | Aacademy Adult Day &seniorliiving Facilityllc | Custodial Care Facility | 168 Davedeharahara Dr, Sylvania, GA 30467 | 2012-05-09 |
| 1407010689 | Screven County Family Medicine | Family Medicine | 215 Mims Road, Sylvania, GA 30467 | 2008-07-16 |
| 1518127687 | Sherma Peter | Family Medicine | 213 Mims Road, Sylvania, GA 30467 | 2008-06-12 |
| 1508925454 | Mppg, Inc. | Family Medicine | 105 Rocky Ford Road, Sylvania, GA 30467 | 2006-12-06 |
| 1891337572 | Allan Kipngeno | Pharmacist | 305 W Ogeechee St, Sylvania, GA 30467 | 2019-10-14 |
| 1770822066 | Screven County Hospital, LLC | Surgery | 102 Rocky Ford Rd, Sylvania, GA 30467 | 2013-02-06 |
| 1588903884 | Tattnall Hospital Company, LLC | Surgery | 102 Rocky Ford Rd, Sylvania, GA 30467 | 2013-02-06 |
| Find all providers in zip 30467 | ||||
| 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 |
|---|---|---|---|---|
| 1194064832 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 209a Mims Rd, Sylvania, GA 30467-1994 | 2013-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194337592 | Stefan Vincent Goldberg | Internal Medicine | 3239 Bolero Dr, Atlanta, GA 30341-5705 | 2020-08-18 |
| 1366064164 | Southeast Lung & Critical Care Specialists | Internal Medicine | 1745 City Circle Rd, Baxley, GA 31513-7059 | 2020-05-14 |
| 1205474954 | Tift Regional Health System, Inc | Internal Medicine | 1499 Kennedy Road, Suite A, Tifton, GA 31794-4177 | 2019-12-12 |
| 1659845790 | Frank J Demarco Jr Md LLC | Internal Medicine | 4465 Nelson Brogdon Blvd, Buford, GA 30518-3487 | 2019-01-11 |
| 1063915338 | Trident Pulmonary and Critical Care PC | Internal Medicine | 483 Upper Riverdale Rd Sw Ste E, Riverdale, GA 30274-2579 | 2018-03-13 |
| 1194235853 | Covenant Medical Group LLC | Internal Medicine | 3605 Sandy Plains Rd Ste 240-235, Marietta, GA 30066-3068 | 2017-10-09 |
| 1235659814 | Southeast Lung & Criticial Care Specialists, PC | Internal Medicine | 5356 Reynolds St Ste 303, Savannah, GA 31405-6018 | 2017-06-23 |
| 1619355427 | Southeast Lung & Critical Care Specialists, PC. | Internal Medicine | 400 Cedar St Ste 106, Candler County Hospital, Metter, GA 30439-3338 | 2015-05-13 |
| 1770989154 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 800 East 68th Street, Landmark Hospital, Savannah, GA 31405 | 2014-11-12 |
| 1407267511 | Akshay Bhatnagar | Internal Medicine | 2301 Newnan Crossing Blvd E Ste 200, Newnan, GA 30265-2576 | 2014-05-12 |
| Find all providers with the same taxonomy | ||||
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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.