Michelle R Zeanah, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

056388 Issued in GA

Practice address

406 Savannah Ave
Statesboro, GA 30458-5102

Phone

(912) 489-4379

Fax

(912) 681-4379

NPI assigned

Jul 27, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michelle.zeanah.1@27415.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michelle Zeanah MD PC

  dba Behavioral Pediatrics of Rural Georgia

  • Medical Specialty Clinic/Center
  • Statesboro, GA
  • NPI 1760981609
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1013931617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 SAVANNAH AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585102",
            "telephone_number": "912-489-4379",
            "fax_number": "912-681-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SAVANNAH AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585102",
            "telephone_number": "912-489-4379",
            "fax_number": "912-681-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEANAH",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "056388",
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "GA",
            "license": "56388",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "783381411B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Youssef
• Youtherapy
• Sae Young Yu, O.D.
• Patricia Zambeck
• Lane Peyton Zeagler
• Jennifer A Zimmerman, D.O.

• Pediatrics Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.