NPIMap

Organization Active NPI

Statewide Healthcare, Inc.

  • Adult Care Home Facility
  • Savannah, GA
National Provider Identifier
1053477877
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
621610 Issued in GA
Legal business name
STATEWIDE HEALTHCARE, INC.
Practice address
714 Martin Luther King Jr Blvd
Suit 100
Savannah, GA 31401-5570
Phone
(912) 231-8958
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
J. Craig Gordon
Title
Ceo
Phone
(912) 231-8958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 621610 GA Primary

Addresses

Primary practice location

714 Martin Luther King Jr Blvd
Suit 100
Savannah, GA 31401-5570

Mailing address

714 Martin Luther King Jr Blvd
Suit 100
Savannah, GA 31401-5570
Phone (912) 231-8958

National Provider Directory

National Provider Directory
Tax ID family
Statewide Healthcare Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053477877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUIT 100",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314015570",
            "telephone_number": "912-231-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUIT 100",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314015570",
            "telephone_number": "912-231-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEWIDE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "J. CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-231-8958"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "GA",
            "license": "621610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.