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SOUTHERN GASTROENTEROLOGY ASSOCIATES PC
NPI 1376659870
Specialist in South Boston, VA

Active since August 21, 2006
1129 N MAIN ST STE G, SOUTH BOSTON, VA 24592(434) 572-8196(434) 572-8341 Get Directions Write a Review

NPPES record last updated: January 7, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 7, 2022, Nov 18, 2021 (2 updates tracked since 2021).

About Southern Gastroenterology Associates Pc NPPES

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

SOUTHERN GASTROENTEROLOGY ASSOCIATES PC (NPI 1376659870) is a healthcare organization registered as a specialist in South Boston, Virginia and active in the NPI registry since August 2006. The organization maintains a secondary practice location in South Boston and lists Nicole Palmer, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1376659870
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTHERN GASTROENTEROLOGY ASSOCIATES PC
Location Address1129 N MAIN ST STE GSouth Boston, VA 24592-2547
Mailing Address1129 N Main St Ste GSouth Boston, VA 24592-2547 · (434) 572-8196 · Fax (434) 572-8341
Phone(434) 572-8196
Fax(434) 572-8341
Organization SubpartNo
Authorized OfficialNicole PalmerPractice Manager · (434) 572-8196
Enumeration DateAugust 21, 2006
Last NPPES UpdateJanuary 7, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 7, 2022
✔ NPI 1376659870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1129 N MAIN ST STE G, South Boston, VA 24592
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Secondary Practice Location 1

Location 12232 Wilborn AveSouth Boston, VA 24592-1662 · Phone (434) 572-8196 · Fax (434) 572-4549

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SURESH GEHAN JAYATILAKA M.D.
Internal Medicine (Gastroenterology)
1129 N MAIN ST STE G
SOUTH BOSTON, VA 24592
Halifax County (434) 572-8196
SETH GUPTON NP
Nurse Practitioner (Family)
1129 N MAIN ST STE G
SOUTH BOSTON, VA 24592
Halifax County (434) 572-8196
BAKUL KUMAR PATEL
Internal Medicine (Gastroenterology)
1129 N MAIN ST STE G
SOUTH BOSTON, VA 24592
Halifax County (434) 572-8196

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 Gastroenterology Associates PC's NPI number?

The NPI number for Southern Gastroenterology Associates PC is 1376659870. It was assigned to this organization in the NPPES registry on August 21, 2006.

Where is Southern Gastroenterology Associates PC located?

Southern Gastroenterology Associates PC is located at 1129 N Main St Ste G, South Boston, VA 24592. The listed phone number is (434) 572-8196.

What is Southern Gastroenterology Associates PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Southern Gastroenterology Associates PC was last updated on January 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.