Southern Physician Group Management LLC
NPI 1770162695 · Internal Medicine Physician · Nacogdoches, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southern Physician Group Management LLC is a Internal Medicine Physician organization in Nacogdoches, TX (NPI 1770162695).
Provider details
- NPI number
- 1770162695
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Grant Douglass, President(361) 729-0646
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Emergency Medicine Physician207P00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-04-07
- Last updated
- 2022-07-26
- Certified
- 2022-07-26
Frequently asked questions
- What is Southern Physician Group Management LLC's NPI number?
- Southern Physician Group Management LLC's National Provider Identifier (NPI) is 1770162695, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Physician Group Management LLC?
- Southern Physician Group Management LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Southern Physician Group Management LLC located?
- Southern Physician Group Management LLC's practice location on file with NPPES is 1204 N Mound St, Nacogdoches, TX 75961-4027.
- What is Southern Physician Group Management LLC's phone number?
- The practice phone number listed in the NPPES registry for Southern Physician Group Management LLC is (936) 564-4611.
- Does Southern Physician Group Management LLC accept Medicare?
- Southern Physician Group Management LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southern Physician Group Management LLC?
- The authorized official listed on Southern Physician Group Management LLC's NPPES record is Grant Douglass, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Physician Group Management LLC's NPI active?
- Yes — Southern Physician Group Management LLC's NPI (1770162695) is active in the NPPES registry as of the last update on 2022-07-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.