SJC Thoracic Services, LLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

SJC THORACIC SERVICES, LLC

Practice address

225 Candler Dr Ste 201
Savannah, GA 31405-6092

Phone

(912) 819-5757

Fax

(912) 819-5753

NPI assigned

Sep 12, 2022

Organization subpart

No

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

Authorized official

Name

Pam Proman

Title

Administrator

Phone

(912) 819-7745

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

Enrollment records 2

Locations

Practitioners 3

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

• Michael D Mullins, MD

  • Pulmonary Disease Physician
  • Savannah, GA
  • NPI 1285602854

  SC

  Medicare reassignment Care Compare group NPD
• James Polites

  • Physician Assistant
  • Savannah, GA
  • NPI 1669251005

  SC

  Medicare reassignment Care Compare group
• Edith Utley, PA

  • Physician Assistant
  • Savannah, GA
  • NPI 1003951658

  SC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1114649779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CANDLER DR STE 201",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056092",
            "telephone_number": "912-819-5757",
            "fax_number": "912-819-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CANDLER DR STE 201",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056092",
            "telephone_number": "912-819-5757",
            "fax_number": "912-819-5753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Arley Way Ste 101B",
            "address_purpose": "LOCATION",
            "city": "Bluffton",
            "state": "SC",
            "postal_code": "299108860",
            "country_code": "US",
            "telephone_number": "912-819-5757",
            "fax_number": "912-819-5753",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Doctors Dr Ste O",
            "address_purpose": "LOCATION",
            "city": "Douglas",
            "state": "GA",
            "postal_code": "315332202",
            "country_code": "US",
            "telephone_number": "912-383-5655",
            "fax_number": "912-389-2117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 Candler Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056093",
            "country_code": "US",
            "telephone_number": "912-352-1700",
            "fax_number": "912-354-8545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SJC THORACIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "PROMAN",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "912-819-7745"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SJC General Surgery LLC
• SJC Home Health Services Inc
• SJC Medical Group Inc
• SJC Oncology Services - Georgia, LLC
• SJC Oncology Services-Georgia, LLC
• Craig Kevin Skalla, DPM
• Ellen Skeadas Grody, PA-C
• William Douglas Skelton, MD
• Skidaway Behavioral Institute LLC
• Skidaway Health and Living Services, Inc.

• Pulmonary Disease Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Pulmonary Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.