NPIMap

Organization Active NPI

Ear, Nose & Throat Associates of Savannah, PC

  • Otolaryngology Physician
  • Savannah, GA
National Provider Identifier
1134322142
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR, NOSE & THROAT ASSOCIATES OF SAVANNAH, PC
Practice address
5201 Frederick Street
Savannah, GA 31405-4501
Phone
(912) 351-3030
Fax
(912) 351-3039
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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

Authorized official

Name
Fred L Daniel, MDNPI 1013918150
Title
MD
Phone
(912) 350-3030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

5201 Frederick Street
Savannah, GA 31405-4501

Mailing address

5201 Frederick Street
Savannah, GA 31405-4501
Phone (912) 351-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000282 GA Part B Supplier - Clinic/Group Practice 8426030479 Receives reassigned benefits from 16 practitioners
8 other NPIs on this enrollment
Practice locations: Pooler, GA; Savannah, GA; Statesboro, GA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1000 Towne Center Blvd
Ste 200
Pooler, GA 31322
Phone (912) 330-8075

13040 Abercorn St
Ste 1
Savannah, GA 31419
Phone (912) 927-2848

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505692800000",
    "number": "1134322142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 FREDERICK STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054501",
            "telephone_number": "912-351-3030",
            "fax_number": "912-351-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 FREDERICK STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054501",
            "telephone_number": "912-351-3030",
            "fax_number": "912-351-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE & THROAT ASSOCIATES OF SAVANNAH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2017-09-18",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "912-350-3030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; 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.