NPIMap

Organization Active NPI

Tattnall Hospital Company LLC

  • Pain Medicine Physician
  • Richmond Hill, GA
National Provider Identifier
1265360317
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
TATTNALL HOSPITAL COMPANY LLC
Practice address
200 Interchange Dr
Richmond Hill, GA 31324-7668
Phone
(912) 721-2262
NPI assigned
May 11, 2026
Organization subpart
Yes
Parent organization
TATTNALL HOSPITAL COMPANY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

Name
Mr. David Alex Villa
Title
Ceo
Phone
(912) 629-7797

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X
Pain Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P2900X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

200 Interchange Dr
Richmond Hill, GA 31324-7668

Mailing address

440 Mall Blvd Ste C
Savannah, GA 31406-4868
Phone (912) 644-3340

Other names 1

  • Optim Medical Center - Tattnall Richmond Hill Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080915000167 GA Part B Supplier - Clinic/Group Practice 6204907124 Receives reassigned benefits from 63 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Reidsville, GA; Swainsboro, GA; Richmond Hill, GA; Rincon, GA; Sandersville, GA; Savannah, GA; Statesboro, GA; Sylvania, GA…

National Provider Directory

National Provider Directory
Tax ID family
Coastal Imaging21 organizations share this tax ID, including this one
Part of
Coastal Imaging

Other organizations with this tax ID 19

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

View all 19

Locations

200 Interchange Dr
Richmond Hill, GA 31324
Phone (912) 721-2262

NPI Registry JSON

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

{
    "created_epoch": "1778457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1265360317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MALL BLVD STE C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064868",
            "telephone_number": "912-644-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 INTERCHANGE DR",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313247668",
            "telephone_number": "912-721-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TATTNALL HOSPITAL COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TATTNALL HOSPITAL COMPANY LLC",
        "enumeration_date": "2026-05-11",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALEX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-629-7797",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optim Medical Center - Tattnall Richmond Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond Hill, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.