Active NPI
MPPG, Inc.
- Surgery Physician
- Savannah, GA
National Provider Identifier
1497822324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- MPPG, INC.
- Doing business as
- Savannah Surgical Group
- Practice address
- 4750 Waters Ave
Suite 202
Savannah, GA 31404-6200 - Phone
- (912) 350-7412
- Fax
- (912) 350-7297
- NPI assigned
- Nov 29, 2006
- 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
- Robin J. Maddox
- Title
- Provider Enrollment Coordinator
- Phone
- (912) 350-9335
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Trauma Physician | 207XX0801X | |||
| Surgery Physician | 208600000X | Primary | ||
| Surgical Critical Care Physician | 2086S0102X | |||
| Trauma Surgery Physician | 2086S0127X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
4750 Waters Ave
Suite 202
Savannah, GA 31404-6200
Mailing address
4750 Waters Ave
Suite 202
Savannah, GA 31404-6200
Phone (912) 350-7412
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GPA611 | Medicaid | SC |
Other names 1
- Savannah Surgical Group
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1317686400000",
"number": "1497822324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 WATERS AVE",
"address_2": "SUITE 202",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314046200",
"telephone_number": "912-350-7412",
"fax_number": "912-350-7297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4750 WATERS AVE",
"address_2": "SUITE 202",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314046200",
"telephone_number": "912-350-7412",
"fax_number": "912-350-7297"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MPPG, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-29",
"last_updated": "2011-10-04",
"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"
},
"taxonomies": [
{
"code": "207XX0801X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Orthopaedic Trauma",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
},
{
"code": "2086S0102X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery, Surgical Critical Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery, Trauma Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GPA611",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Savannah Surgical Group",
"code": "3",
"type": "Doing Business As"
}
]
}
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 Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.