Organization Active NPI

Cossio Pediatrics LLC

  • Specialist
  • Savannah, GA
National Provider Identifier
1083878920
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036357 Issued in GA
Legal business name
COSSIO PEDIATRICS LLC
Practice address
334 Stephenson Ave
Savannah, GA 31405-5929
Phone
(912) 354-3130
Fax
(912) 354-5860
NPI assigned
Jul 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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

Authorized official

Name
Samantha Fitton
Title
Office Manager
Phone
(912) 354-3130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036357 GA Primary

Addresses

Primary practice location

334 Stephenson Ave
Savannah, GA 31405-5929

Mailing address

334 Stephenson Ave
Savannah, GA 31405-5929
Phone (912) 354-3130

Other identifiers 6

IdentifierTypeStateIssuer
000872638AMedicaidGA
1861423295OtherGAINDIDIVUAL NATIONAL PROVIDER #
000874244AMedicaidGA
1912938366OtherGAINDIVIDUAL NATIONAL PROVIDER #
000532727AMedicaidGA
1811922693OtherGAINDIVIDUAL NATIONAL PROVIDER #

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0903538Cossio Pediatrics334 Stephenson Avenue, Savannah, GA 31405Certificate of waiverJul 30, 2027

National Provider Directory

National Provider Directory

Locations

334 Stephenson Ave
Savannah, GA 31405
Phone (912) 354-3130

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508284800000",
    "number": "1083878920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 STEPHENSON AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055929",
            "telephone_number": "912-354-3130",
            "fax_number": "912-354-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 STEPHENSON AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055929",
            "telephone_number": "912-354-3130",
            "fax_number": "912-354-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSSIO PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2017-10-18",
        "status": "A",
        "authorized_official_last_name": "FITTON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-354-3130"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "036357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000872638A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIDIVUAL NATIONAL PROVIDER #",
            "identifier": "1861423295",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000874244A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL  NATIONAL PROVIDER #",
            "identifier": "1912938366",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000532727A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NATIONAL PROVIDER #",
            "identifier": "1811922693",
            "state": "GA"
        }
    ],
    "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 Oct 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.