Organization Active NPI

Gastroenterology Institute, PC

  • Gastroenterology Physician
  • Statesboro, GA
National Provider Identifier
1093039760
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROENTEROLOGY INSTITUTE, PC
Practice address
114 Hill Pond LN
Statesboro, GA 30458-0872
Phone
(912) 681-6944
Fax
(912) 681-8744
NPI assigned
Mar 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Authorized official

Name
Dr. Joseph M Hathaway Jr., MD
Title
Owner
Phone
(912) 681-6944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

114 Hill Pond LN
Statesboro, GA 30458-0872

Mailing address

114 Hill Pond LN
Statesboro, GA 30458-0872
Phone (912) 681-6944

Other identifiers 1

IdentifierTypeStateIssuer
000900501GMedicaidGA

National Provider Directory

National Provider Directory

Locations

114 Hill Pond Ln
Statesboro, GA 30458
Phone (912) 681-6944

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGBICA

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1093039760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HILL POND LN",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580872",
            "telephone_number": "912-681-6944",
            "fax_number": "912-681-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HILL POND LN",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580872",
            "telephone_number": "912-681-6944",
            "fax_number": "912-681-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY INSTITUTE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "HATHAWAY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-681-6944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000900501G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.