Individual provider Active NPI

Manning M. Goldsmith III, M.D.

  • Otolaryngology Physician
  • Savannah, GA
National Provider Identifier
1164464111
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
0215161 Issued in GA
Practice address
5356 Reynolds St
Suite 505
Savannah, GA 31405-6106
Phone
(912) 644-5300
Fax
(912) 644-5260
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0215161 GA Primary

Addresses

Primary practice location

5356 Reynolds St
Suite 505
Savannah, GA 31405-6106

Mailing address

5356 Reynolds St
Suite 505
Savannah, GA 31405-6106
Phone (912) 644-5300

Other identifiers 1

IdentifierTypeStateIssuer
000281113PMedicaidGA

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
I20040408000356 GA Practitioner - Otolaryngology 4789677220 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0215161GAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Candler ENT Practice, LLC Otolaryngology CurrentSince Aug 1, 2014 Accepting new patients
Georgia Ear Associates PC PastSince Apr 1, 2007 Accepting new patients

Locations

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

5356 Reynolds St
Ste 505
Savannah, GA 31405

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

Interoperability endpoints

  • Direct secure messaging: mgoldsmith@gent2091.srs-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1164464111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5356 REYNOLDS ST",
            "address_2": "SUITE 505",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056106",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5356 REYNOLDS ST",
            "address_2": "SUITE 505",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056106",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "MANNING",
        "middle_name": "M.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "0215161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000281113P",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.