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Organization

Southern Crescent Neurological Clinic,pc

NPI Record: ActivePsychiatry & Neurology — Neurology
NPI1013052182
Fayetteville, Georgia

Provider's NPPES record last updated: June 21, 2018

Overview

Entity Type
Organization
NPI
1013052182
Primary Specialty
Psychiatry & Neurology — Neurology
Practice Location
Fayetteville, Georgia
Organization Subpart
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 18, 2026, 9:34 PM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Psychiatry & Neurology

    Neurology

    Allopathic & Osteopathic Physicians

    Primary

    A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

    Taxonomy code 2084N0400X

Provider-Reported License Information

Psychiatry & Neurology (Georgia)
031058
License numbers are reported by the provider to NPPES and are not independently verified by NPISignal against any state licensing board. Confirm current license status directly with the issuing state board.

Practice Locations

Practice Location

1250 Highway 54 W

102

Fayetteville, Georgia 30214-4545

Phone: (770) 719-2965

Record Information

Enumeration Date
February 20, 2007
Provider's NPPES Record Last Updated
June 21, 2018
NPISignal NPPES Dataset
August 2026

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