Active NPI
Ochsner 65 Plus Savannah LLC
- Internal Medicine Physician
- Savannah, GA
National Provider Identifier
1508680679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- OCHSNER 65 PLUS SAVANNAH LLC
- Practice address
- 48 E Derenne Ave
Savannah, GA 31405 - Phone
- (912) 527-3231
- NPI assigned
- Nov 14, 2024
- 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
- Thomas Duncan
- Title
- Ceo
- Phone
- (912) 527-3231
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
48 E Derenne Ave
Savannah, GA 31405
Mailing address
48 E Derenne Ave
Savannah, GA 31405
Other names 1
- Ochsner 65 Plus- Savannah
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251006000465 | GA | Part B Supplier - Clinic/Group Practice | 1557867843 |
Receives reassigned benefits from 4 practitioners Practice locations: Savannah, GA |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
48 E Derenne Ave
Savannah, GA 31405
Phone (912) 527-3231
48 E Derenne Ave
Savannah, GA 31405
Phone (912) 527-3231
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731542400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731542400000",
"number": "1508680679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 E DERENNE AVE",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "31405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 E DERENNE AVE",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "31405",
"telephone_number": "912-527-3231"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OCHSNER 65 PLUS SAVANNAH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-11-14",
"last_updated": "2024-11-14",
"certification_date": "2024-11-13",
"status": "A",
"authorized_official_last_name": "DUNCAN",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "912-527-3231"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Ochsner 65 Plus- Savannah",
"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 Nov 14, 2024; 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.