SOUTHERN SURGICAL ASSISTANTS, LLC
NPI 1063687267
Nurse Practitioner in Braselton, GA

Q: What is Southern Surgical Assistants, LLC's NPI number?

The NPI number for Southern Surgical Assistants, LLC is 1063687267. It was assigned to this organization in the NPPES registry on April 28, 2008.

Q: What is Southern Surgical Assistants, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since April 28, 2008

5742 ALLEE WAY, BRASELTON, GA 30517(678) 591-8344(770) 965-3365 Get Directions Write a Review

NPPES record last updated: November 28, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Southern Surgical Assistants, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN SURGICAL ASSISTANTS, LLC (NPI 1063687267) is a healthcare organization registered as a nurse practitioner in Braselton, Georgia and active in the NPI registry since April 2008. The organization lists Joseph Henry Kanclerz, Owner, as its authorized official.

NPPES Registry Identity

NPI1063687267

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameSOUTHERN SURGICAL ASSISTANTS, LLC

Location Address5742 ALLEE WAYBraselton, GA 30517

Mailing AddressPo Box 7042Chestnut Mountain, GA 30502-0042 · (678) 591-8344 · Fax (770) 965-3365

Phone(678) 591-8344

Fax(770) 965-3365

Organization SubpartNo

Authorized OfficialJoseph Henry KanclerzOwner · (678) 591-8644

Enumeration DateApril 28, 2008

Last NPPES UpdateNovember 28, 2018

✔ NPI 1063687267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

5742 ALLEE WAY, Braselton, GA 30517

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southern Surgical Assistants, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Southern Surgical Assistants, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Joseph Kanclerz, MSN, NP-C, RNFA

Nurse Practitioner

NPI 1164697355

5742 ALLEE WAY
Braselton, GA 30517

(678) 591-8344

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Surgical Assistants, LLC's NPI number?

The NPI number for Southern Surgical Assistants, LLC is 1063687267. It was assigned to this organization in the NPPES registry on April 28, 2008.

Where is Southern Surgical Assistants, LLC located?

Southern Surgical Assistants, LLC is located at 5742 Allee Way, Braselton, GA 30517. The listed phone number is (678) 591-8344.

What is Southern Surgical Assistants, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Southern Surgical Assistants, LLC enrolled in Medicare?

Yes. Southern Surgical Assistants, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southern Surgical Assistants, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Southern Surgical Assistants, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southern Surgical Assistants, LLC was last updated on November 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.