NPIMap

Organization Active NPI

Applecare/Memorial Immediate Care Joint Venture LLC

  • Clinic/Center
  • Pooler, GA
National Provider Identifier
1053772152
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
APPLECARE/MEMORIAL IMMEDIATE CARE JOINT VENTURE LLC
Practice address
105 Grand Central Blvd Ste 108
Pooler, GA 31322-4148
Phone
(912) 748-1515
Fax
(912) 748-7707
NPI assigned
Mar 16, 2016
Last updated
Oct 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Authorized official

Name
Heidi D Nash
Title
Administrative Coordinator
Phone
(912) 349-4945

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

105 Grand Central Blvd Ste 108
Pooler, GA 31322-4148

Mailing address

401 Mall Blvd
Suite 202E
Savannah, GA 31406-4862
Phone (912) 349-4945

Other names 1

  • AppleCare Pooler Other name

National Provider Directory

National Provider Directory
Tax ID family
Applecare Memorial Immediate Care Joint Venture LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1458086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1053772152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MALL BLVD",
            "address_2": "SUITE 202E",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064862",
            "telephone_number": "912-349-4945",
            "fax_number": "912-349-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 GRAND CENTRAL BLVD STE 108",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224148",
            "telephone_number": "912-748-1515",
            "fax_number": "912-748-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLECARE/MEMORIAL IMMEDIATE CARE JOINT VENTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-16",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "NASH",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATIVE COORDINATOR",
        "authorized_official_telephone_number": "912-349-4945"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AppleCare Pooler",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.