Active NPI
Cossio Pediatrics LLC
- Specialist
- Savannah, GA
National Provider Identifier
1083878920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 036357
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000872638A | Medicaid | GA | |
| 1861423295 | Other | GA | INDIDIVUAL NATIONAL PROVIDER # |
| 000874244A | Medicaid | GA | |
| 1912938366 | Other | GA | INDIVIDUAL NATIONAL PROVIDER # |
| 000532727A | Medicaid | GA | |
| 1811922693 | Other | GA | INDIVIDUAL NATIONAL PROVIDER # |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0903538 | Cossio Pediatrics | Certificate of waiver | Jul 30, 2027 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Pediatrics Physician
- Savannah, GA
- NPI 1811922693
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.