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SOUTHEASTERN ENDOSCOPY CENTER LLC
NPI 1932819554
Clinic/Center - Ambulatory Surgical in Columbus, GA

Active since December 05, 2022CLIA 11D2274820 · Waiver
2200 HAMILTON RD STE A, COLUMBUS, GA 31904(706) 655-8800 Get Directions Write a Review

NPPES record last updated: December 19, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 19, 2022, Dec 5, 2022 (2 updates tracked since 2022).

About Southeastern Endoscopy Center Llc NPPES

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

SOUTHEASTERN ENDOSCOPY CENTER LLC (NPI 1932819554) is a healthcare organization registered as an ambulatory surgical in Columbus, Georgia and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through January 10, 2027 and lists Shane Darrah, Ceo, as its authorized official.

NPPES Registry Identity

NPI1932819554
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameSOUTHEASTERN ENDOSCOPY CENTER LLC
Location Address2200 HAMILTON RD STE AColumbus, GA 31904-8889
Mailing AddressPo Box 8629Columbus, GA 31908-8629
Phone(706) 655-8800
Organization SubpartNo
Authorized OfficialShane DarrahCeo · (706) 326-6743
Enumeration DateDecember 5, 2022
Last NPPES UpdateDecember 19, 20222 updates tracked since enumeration
NPPES CertifiedDecember 19, 2022
✔ NPI 1932819554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
2200 HAMILTON RD STE A, Columbus, GA 31904
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southeastern Endoscopy Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Southeastern Endoscopy Center LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Mark Fortson, M.D.
Gastroenterology
NPI 1457452591
2200 HAMILTON RD STE B
Columbus, GA 31904
(706) 655-8800
✔ PECOSSame address
Carter Wallace, MD
Gastroenterology
NPI 1497037899
2200 HAMILTON RD STE B
Columbus, GA 31904
(706) 655-8800
✔ PECOSSame address
Shane Darrah, M.D.
Interventional Cardiology
NPI 1679557375
2121 WARM SPRINGS RD
Columbus, GA 31904
(706) 243-4500
✔ PECOS✔ Accepts Medicare1.7 mi
Daniel Schoenborn, DO
Gastroenterology
NPI 1326252503
2300 MANCHESTER EXPY STE A 201
Columbus, GA 31904
(706) 320-2766
✔ PECOS✔ Accepts Medicare2.1 mi

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2274820

Southeastern Endoscopy Center · Columbus, GA
Active · expires Jan 10, 2027
CLIA Number11D2274820
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJanuary 11, 2025
Certificate Expiration DateJanuary 10, 2027
Laboratory DirectorJordan M. Joiner
Laboratory Phone(706) 655-8800
Laboratory LocationSoutheastern Endoscopy Center2200 Hamilton Road, Suite A, Columbus, GA 31904
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
27 services27 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
18 services18 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
18 services18 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
14 services13 patients

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 Southeastern Endoscopy Center LLC's NPI number?

The NPI number for Southeastern Endoscopy Center LLC is 1932819554. It was assigned to this organization in the NPPES registry on December 5, 2022.

Where is Southeastern Endoscopy Center LLC located?

Southeastern Endoscopy Center LLC is located at 2200 Hamilton Rd Ste A, Columbus, GA 31904. The listed phone number is (706) 655-8800.

What is Southeastern Endoscopy Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Is Southeastern Endoscopy Center LLC enrolled in Medicare?

Yes. Southeastern Endoscopy Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southeastern Endoscopy Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Southeastern Endoscopy Center 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. The largest specialties are Gastroenterology (3) and Interventional Cardiology (1). Of these, 2 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Southeastern Endoscopy Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2274820) is associated with this NPI, valid through January 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southeastern Endoscopy Center LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Southeastern Endoscopy Center LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeastern Endoscopy Center LLC was last updated on December 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.