Organization Active NPI

Savannah Pelvic Health and Wellness, LLC.

  • Physical Therapist
  • Pooler, GA
National Provider Identifier
1487363040
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SAVANNAH PELVIC HEALTH AND WELLNESS, LLC.
Practice address
408 US Highway 80 SW
Pooler, GA 31322-2541
Phone
(912) 503-0516
Fax
(912) 600-1994
NPI assigned
Nov 22, 2022
Last updated
Nov 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Jasmine D Polk, PTNPI 1801298781
Title
Owner/Physical Therapist
Phone
(912) 503-0516

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

408 US Highway 80 SW
Pooler, GA 31322-2541

Mailing address

209 Thatcher St
Guyton, GA 31312-5842
Phone (912) 503-0516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221130001932 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8628446382 Receives reassigned benefits from 4 practitioners
Practice locations: Bloomingdale, GA

National Provider Directory

National Provider Directory

Locations

106 E US Highway 80
Ste G
Bloomingdale, GA 31302
Phone (912) 420-4910

Practitioners & affiliated clinicians

Practitioners 4

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": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1487363040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 THATCHER ST",
            "city": "GUYTON",
            "state": "GA",
            "postal_code": "313125842",
            "telephone_number": "912-503-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 US HIGHWAY 80 SW",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222541",
            "telephone_number": "912-503-0516",
            "fax_number": "912-600-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAVANNAH PELVIC HEALTH AND WELLNESS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "912-503-0516",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 22, 2022; 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.