NPIMap

Organization Active NPI

Mba Community Clinic

Doing business as Community Clinic

  • Primary Care Clinic/Center
  • Savannah, GA
National Provider Identifier
1083007355
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MBA COMMUNITY CLINIC
Doing business as
Community Clinic
Practice address
4395 Ogeechee Rd
Ste 209
Savannah, GA 31405-1249
Phone
(912) 335-8934
Fax
(912) 228-3046
NPI assigned
Mar 11, 2015
Last updated
Aug 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Authorized official

Name
Mr. Maurice S ByrdNPI 1710133475
Title
Owner
Phone
(912) 335-8934

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Health Service Clinic/Center 261QH0100X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

4395 Ogeechee Rd
Ste 209
Savannah, GA 31405-1249

Mailing address

4395 Ogeechee Rd
Ste 209
Savannah, GA 31405-1249
Phone (912) 208-3261

Other names 1

  • COMMUNITY CLINIC Doing business as

National Provider Directory

National Provider Directory

Locations

4395 Ogeechee Rd
Unit 209
Savannah, GA 31405
Phone (912) 208-0726

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1083007355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4395 OGEECHEE RD",
            "address_2": "STE 209",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314051249",
            "telephone_number": "912-208-3261",
            "fax_number": "912-228-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4395 OGEECHEE RD",
            "address_2": "STE 209",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314051249",
            "telephone_number": "912-335-8934",
            "fax_number": "912-228-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBA COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-335-8934",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY CLINIC",
            "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 Aug 4, 2015; 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.