Statesboro ENT & FPS Clinic, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

024663 Issued in GA

Legal business name

STATESBORO ENT & FPS CLINIC, P.C.

Doing business as

Statesboro ENT & H Clinic

Practice address

106 Proctor St
Statesboro, GA 30458-1351

Phone

(912) 764-8200

Fax

(912) 489-2954

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Thomas M Crews, MDNPI 1518910082

Title

Owner

Phone

(912) 764-8200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Statesboro ENT & H Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas M Crews, MD

  • Specialist
  • Statesboro, GA
  • NPI 1518910082
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1396791976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 PROCTOR ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581351",
            "telephone_number": "912-764-8200",
            "fax_number": "912-489-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PROCTOR ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581351",
            "telephone_number": "912-764-8200",
            "fax_number": "912-489-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESBORO ENT & FPS CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "CREWS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-764-8200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "024663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID REFERENCE #",
            "identifier": "REF761734385",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Statesboro ENT & H Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Statesboro Ambul Surg Ctr Inc
• Statesboro Ambulatory Surgery Center Inc
• Statesboro Ambulatory Surgery Center, Inc
• Statesboro Cardiology, PC
• Statesboro Children's Dental Center, PC
• Statesboro ENT & Sinus Center
• Statesboro ENT Surgical Center
• Statesboro ENT Surgical Center
• Statesboro Gastroenterology Inc
• Statesboro General Medical Clinic LLC

• Specialist in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.