Active NPI
MPPG, Inc.
Doing business as Memorial Urgent Care
- Emergency Medicine Physician
- Pooler, GA
National Provider Identifier
1396086062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- MPPG, INC.
- Doing business as
- Memorial Urgent Care
- Practice address
- 110 Medical Park Dr
Pooler, GA 31322-1956 - Phone
- (921) 748-1515
- Fax
- (912) 748-7707
- NPI assigned
- Mar 6, 2013
- Last updated
- May 13, 2014
- Organization subpart
- No
NPPES NPI Registry
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) 350-9335
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | ||
| Emergency Medicine Physician | 207P00000X | NU | Primary | |
| Family Medicine Physician | 207Q00000X | NU | ||
| General Practice Physician | 208D00000X | NU |
Addresses
Primary practice location
110 Medical Park Dr
Pooler, GA 31322-1956
Mailing address
110 Medical Park Dr
Pooler, GA 31322-1956
Phone (921) 748-1515
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30003167A | Medicaid | GA | |
| CH5121 | Other | GA | RAILROAD MEDICARE |
Other names 1
- Memorial Urgent Care
National Provider Directory
National Provider Directory- Tax ID family
- MPPG Inc
Organizations with this tax ID in the same state 22
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Savannah Vascular Surgery, Inc.
- Vascular Surgery Physician
- Vidalia, GA
- NPI 1174691067
-
dba Provident OB/GYN Associates
- Obstetrics & Gynecology Physician
- Richmond Hill, GA
- NPI 1245544519
-
dba Provident OB GYN Associates
- Obstetrics & Gynecology Physician
- Rincon, GA
- NPI 1255408407
-
dba Springfield Medical Associates
- Internal Medicine Physician
- Springfield, GA
- NPI 1346316957
-
dba University Pediatrics
- Pediatric Hematology & Oncology Physician
- Statesboro, GA
- NPI 1356418578
-
dba Savannah Center for Respiratory, Critical Care, and Sleep Medicine
- Pulmonary Disease Physician
- Savannah, GA
- NPI 1376610386
-
dba Savannah Perinatology Associates
- Maternal & Fetal Medicine Physician
- Brunswick, GA
- NPI 1396812582
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362528000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1399939200000",
"number": "1396086062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 MEDICAL PARK DR",
"city": "POOLER",
"state": "GA",
"postal_code": "313221956",
"telephone_number": "921-748-1515",
"fax_number": "912-748-7707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MEDICAL PARK DR",
"city": "POOLER",
"state": "GA",
"postal_code": "313221956",
"telephone_number": "921-748-1515",
"fax_number": "912-748-7707"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MPPG, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-06",
"last_updated": "2014-05-13",
"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": "912-350-9335",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30003167A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CH5121",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Memorial Urgent Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pooler, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.