NPIMap

Organization Active NPI

MPPG, Inc.

Doing business as Rehabilitation Medicine

  • Physical Medicine & Rehabilitation Physician
  • Savannah, GA
National Provider Identifier
1073680070
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
MPPG, INC.
Doing business as
Rehabilitation Medicine
Practice address
4750 Waters Ave
Suite 108
Savannah, GA 31404-6200
Phone
(912) 350-5940
Fax
(912) 350-5991
NPI assigned
Nov 29, 2006
Last updated
May 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Authorized official

Name
Robin J. Maddox
Title
Provider Enrollment Coordinator
Phone
(912) 350-9335

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU Primary
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

4750 Waters Ave
Suite 108
Savannah, GA 31404-6200

Mailing address

4750 Waters Ave
Suite 108
Savannah, GA 31404-6200
Phone (912) 350-5940

Other identifiers 1

IdentifierTypeStateIssuer
GPA590MedicaidSC

Other names 1

  • Rehabilitation Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

4700 Waters Ave
#J
Savannah, GA 31404

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1073680070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 WATERS AVE",
            "address_2": "SUITE 108",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046200",
            "telephone_number": "912-350-5940",
            "fax_number": "912-350-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 WATERS AVE",
            "address_2": "SUITE 108",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046200",
            "telephone_number": "912-350-5940",
            "fax_number": "912-350-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPPG, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "912-350-9335"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPA590",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehabilitation Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 1, 2012; 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.