NPIMap

Individual provider Active NPI

Michael Osmundson

  • Emergency Medicine Physician
  • Savannah, GA
National Provider Identifier
1356394654
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
49520 Issued in GA
Practice address
4700 Waters Ave
Savannah, GA 31404-6220
Phone
(912) 350-3849
NPI assigned
May 18, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 49520 GA Primary

Addresses

Primary practice location

4700 Waters Ave
Savannah, GA 31404-6220

Mailing address

6896 W Snowville Rd
Brecksville, OH 44141-3214

Other identifiers 6

IdentifierTypeStateIssuer
10064445OtherGAAMERIGROUP
N362158OtherGAWELLCARE
G49520MedicaidSC
963738113AOtherGAPEACH STATE HEALTH PLAN
196100OtherGABLUE CROSS BLUE SHIELD
963738113AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49520GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Medical Group, Inc Emergency Medicine Past Accepting new patients
Observation Medicine Physicians of Champaign County, LTD Emergency Medicine PastSince Jul 15, 2014 Accepting new patients
Emergency Medicine Physician Partners of Calaveras County, Inc Emergency Medicine Past Accepting new patients
Emergency Medicine Physician Partners of San Bernardino County, Inc Emergency Medicine Past Accepting new patients
Emergency Medicine Physician Partners of Rancho Mirage, Inc Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Yavapai County, PLLC Emergency Medicine PastSince Jan 1, 2011 Accepting new patients
Seattle Emergency Physicians Services Inc PS Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Mohave County, PLLC Emergency Medicine Past Accepting new patients
Vepema Laborist Medical Group, Inc. PastSince Jun 1, 2021 Accepting new patients
Emergency Medicine Physician Partners of Riverside County, Inc Emergency Medicine Past Accepting new patients
Memorial Health Urgentone, Inc. Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Pinal County, PLLC Emergency Medicine Past Accepting new patients

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1356394654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6896 W SNOWVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441413214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSMUNDSON",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "49520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10064445",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "N362158",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G49520",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE HEALTH PLAN",
            "identifier": "963738113A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "196100",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "963738113A",
            "state": "GA"
        }
    ],
    "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 Mar 7, 2023; 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.