Internal Medicine of Savannah, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERNAL MEDICINE OF SAVANNAH, LLC

Practice address

6413 Waters Ave
Suite 102
Savannah, GA 31406-2711

Phone

(912) 349-6624

Fax

(912) 354-4694

NPI assigned

Feb 26, 2012

Last updated

Sep 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Robin J. Maddox

Title

Provider Enrollment Coordinator

Phone

(912) 350-8977

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 6

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.

• Yulianty D. Kusuma, MD

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1265627145
  Medicare reassignment Care Compare group NPD
• Roberto Jesus Romero, MD

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1467834499
  Medicare reassignment Care Compare group NPD
• Sule Nur Anik, PA

  • Physician Assistant
  • Savannah, GA
  • NPI 1316743560
  Medicare reassignment Care Compare group
• Hailey Dominy Stack, PA-C

  • Physician Assistant
  • Savannah, GA
  • NPI 1033736764
  Medicare reassignment Care Compare group
• Margaret Ann Ellis, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Savannah, GA
  • NPI 1194951764
  NPD (past)
• Rajendrasinh P Mangrola, M.D.

  • Psychiatry Physician
  • Jupiter, FL
  • NPI 1568464949
  NPD (past)

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

{
    "created_epoch": "1330214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1346514114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6413 WATERS AVE",
            "address_2": "SUITE 102",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062711",
            "telephone_number": "912-349-6624",
            "fax_number": "912-354-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6413 WATERS AVE",
            "address_2": "SUITE 102",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062711",
            "telephone_number": "912-349-6624",
            "fax_number": "912-354-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF SAVANNAH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-26",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "MADDOX",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "912-350-8977",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Institute for Personalized Medicine
• Integrated Behavioral Center PC
• Integrated Medical Institute, LLC
• Integrity Counseling Services
• Integrity Diagnostic Network, LLC
• International Medical Supplies
• Intervent International, LLC
• Chanel Jackson Inyang, CLINICAL SOCIAL WORK
• Tatyana Ioffe
• Stephanie D. Ireland - Gordy, M.D.

• 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 Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.