NPIMap

Organization Active NPI

Healthqwest Frontiers LLC

  • Methadone Clinic
  • Savannah, GA
National Provider Identifier
1447521240
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
NTP001070 Issued in GA
Legal business name
HEALTHQWEST FRONTIERS LLC
Practice address
6707 Forest Park Dr
Savannah, GA 31406-2566
Phone
(912) 335-1699
Fax
(912) 335-1352
NPI assigned
Jan 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Authorized official

Name
Robyn Tanis
Title
Executive Director of Contract MGMT
Phone
(856) 533-8762

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NTP001070 GA Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NTP001070 GA
Recovery Care Clinic/Center 261QR0800X

Addresses

Primary practice location

6707 Forest Park Dr
Savannah, GA 31406-2566

Mailing address

1317 Route 73 Ste 200
Mount Laurel, NJ 08054-2202
Phone (856) 439-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200210000510 GA Part B Supplier - Opioid Treatment Program (Otp) 7416383591 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Buford, GA; Savannah, GA; Canton, GA; Macon, GA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2030052Healthqwest Frontiers, LLC6707 Forest Park Drive, Savannah, GA 31406Certificate of waiverSep 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Healthqwest Frontiers LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6707 Forest Park Dr
Savannah, GA 31406
Phone (912) 335-1699

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1447521240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ROUTE 73 STE 200",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542202",
            "telephone_number": "856-439-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6707 FOREST PARK DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062566",
            "telephone_number": "912-335-1699",
            "fax_number": "912-335-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHQWEST FRONTIERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "TANIS",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF CONTRACT MGMT",
        "authorized_official_telephone_number": "856-533-8762"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "GA",
            "license": "NTP001070",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "GA",
            "license": "NTP001070",
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Sep 2, 2021; 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.