Individual provider Active NPI

Frederic C Spector, DPM

  • Foot & Ankle Surgery Podiatrist
  • Savannah, GA
National Provider Identifier
1114906286
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
484 Issued in GA
Practice address
352 Commercial Dr
Savannah, GA 31406
Phone
(912) 354-3668
Fax
(912) 354-0662
NPI assigned
Jan 17, 2006
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 484 GA Primary

Addresses

Primary practice location

352 Commercial Dr
Savannah, GA 31406

Mailing address

352 Commercial Dr
Savannah, GA 31406
Phone (912) 354-3668

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070131000373 GA Practitioner - Podiatry 9234130428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
484GAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
SJC Medical Group Inc CurrentSince Mar 1, 2018 Accepting new patients

Locations

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

352 Commercial Dr
Savannah, GA 31406
Phone (912) 352-3668

602 E 72nd St
Savannah, GA 31405
Phone (912) 819-7800

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1114906286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 COMMERCIAL DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31406",
            "telephone_number": "912-354-3668",
            "fax_number": "912-354-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 COMMERCIAL DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31406",
            "telephone_number": "912-354-3668",
            "fax_number": "912-354-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECTOR",
        "first_name": "FREDERIC",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.