Active NPI
Gastroenterology Institute, PC
- Gastroenterology Physician
- Statesboro, GA
National Provider Identifier
1093039760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000900501G | Medicaid | GA |
National Provider Directory
National Provider DirectoryLocations
114 Hill Pond Ln
Statesboro, GA 30458
Phone (912) 681-6944
Interoperability endpoints
- 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.