Privia Medical Group of Georgia LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRIVIA MEDICAL GROUP OF GEORGIA LLC

Practice address

340 Eisenhower Dr Ste 1200
Savannah, GA 31406-2675

Phone

(912) 443-4200

NPI assigned

Jan 17, 2020

Organization subpart

No

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

Authorized official

Name

Courtney Ivess

Title

Associate Director, Credentialing

Phone

(571) 366-8831

Specialties & licenses 2

Addresses

Tax ID family

Privia Medical GRP of Ga2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD tax ID

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1164052189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N GLEBE RD STE 700",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222034173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 EISENHOWER DR STE 1200",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062675",
            "telephone_number": "912-443-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "IVESS",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR, CREDENTIALING",
        "authorized_official_telephone_number": "571-366-8831"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prism Counseling
• Pritzker Dermatology, P.C.
• Adam Scott Pritzker, M.D.
• Martin S. Pritzker, M.D.
• Private Healthcare Facilities
• Privia Medical Group of Georgia LLC
• Procare Wellness Network Inc
• Alexis Proctor, LCSW
• Sean Jason Proctor, PT
• Professional Optical Services

• Internal Medicine Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.