Individual provider Active NPI

Savanna Dawn Gongloff, FNP-C

  • Nurse Practitioner
  • Bluffton, SC
National Provider Identifier
1427787795
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26116 Issued in SC
Practice address
100 Buckwalter Place Blvd
Bluffton, SC 29910-5022
Phone
(843) 836-7120
NPI assigned
Jun 10, 2022
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26116 SC Primary

Addresses

Primary practice location

100 Buckwalter Place Blvd
Bluffton, SC 29910-5022

Mailing address

100 Buckwalter Place Blvd
Bluffton, SC 29910-5022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221019001263 SC Practitioner - Nurse Practitioner 7315313186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SJC Oncology Services South Carolina LLCGroup PAC ID 0143217273, 14 clinicians

Practice addresses (Care Compare)

100 Buckwalter Place Blvd
Suite 150
Bluffton, SC 29910-5023
Phone (843) 836-7120

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26116SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SJC Oncology Services-South Carolina, LLC Single Specialty CurrentSince Aug 1, 2022 Accepting new patients

Locations

836 E 65th St
Ste 22
Savannah, GA 31405
Phone (912) 819-7878

100 Buckwalter Place Blvd
Ste 150
Bluffton, SC 29910
Phone (843) 208-2895

25 Hospital Center Blvd
Ste 101
Hilton Head Island, SC 29926
Phone (843) 689-6490

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1427787795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BUCKWALTER PLACE BLVD",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299105022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BUCKWALTER PLACE BLVD",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299105022",
            "telephone_number": "843-836-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONGLOFF",
        "first_name": "SAVANNA",
        "middle_name": "DAWN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "26116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.