Organization Active NPI

Savannah Integrative Pediatrics

  • Pediatrics Physician
  • Savannah, GA
National Provider Identifier
1235709601
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SAVANNAH INTEGRATIVE PEDIATRICS
Practice address
132 Stephenson Ave Suite 201
Savannah, GA 31405-3140
Phone
(912) 567-3700
NPI assigned
Jun 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Authorized official

Name
Sommer Clark, ANRP
Title
Manager
Phone
(912) 508-3983

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

132 Stephenson Ave Suite 201
Savannah, GA 31405-3140

Mailing address

132 Stephenson Ave Suite 201
Savannah, GA 31405-8900
Phone (912) 567-3700

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2230226Savannah Integrative Pediatrics, LLC132 Stephenson Avenue Suite 201, Savannah, GA 31405Certificate of waiverJul 20, 2027

National Provider Directory

National Provider Directory

Locations

132 Stephenson Ave
Ste 201
Savannah, GA 31405
Phone (912) 567-3700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1235709601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 STEPHENSON AVE SUITE 201",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314058900",
            "telephone_number": "912-567-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 STEPHENSON AVE SUITE 201",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314053140",
            "telephone_number": "912-567-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAVANNAH INTEGRATIVE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SOMMER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "912-508-3983",
        "authorized_official_credential": "ANRP"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "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 Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.