Individual provider Active NPI

Thomas W. McKee, MD

  • Pediatrics Physician
  • Savannah, GA
National Provider Identifier
1104980754
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
022823 Issued in GA
Practice address
4700 Waters Ave
Savannah, GA 31404
Phone
(912) 350-8180
Fax
(912) 350-7221
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 022823 GA
Pediatrics Physician 208000000X 022823 GA Primary

Addresses

Primary practice location

4700 Waters Ave
Savannah, GA 31404

Mailing address

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8180

Other identifiers 5

IdentifierTypeStateIssuer
000223308BMedicaidGA
10065026OtherGAAMERIGROUP
37BBFTQOtherGAOLD PTAN, TERM'D DUE TO INACTIVITY
349803OtherGAWELLCARE
G22823MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100113000214 GA Practitioner - Critical Care (Intensivists) 4587705553 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
022823GAMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Savannah Pediatric Care, LLC Pediatrics CurrentSince Feb 1, 2018 Accepting new patients
MPPG, Inc. Pediatrics CurrentSince Oct 17, 2009 Accepting new patients
Savannah Health Services, LLC Past Accepting new patients
MPPG, Inc. Past Accepting new patients

Locations

4700 Waters Ave
#J
Savannah, GA 31404

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1104980754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-8180",
            "fax_number": "912-350-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31404",
            "telephone_number": "912-350-8180",
            "fax_number": "912-350-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "THOMAS",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "GA",
            "license": "022823",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "022823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000223308B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10065026",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD PTAN, TERM'D DUE TO INACTIVITY",
            "identifier": "37BBFTQ",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "349803",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G22823",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.