Organization Active NPI

Ochsner 65 Plus Savannah LLC

  • Internal Medicine Physician
  • Savannah, GA
National Provider Identifier
1508680679
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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

Updated by the provider on Nov 14, 2024

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251006000465 GA Part B Supplier - Clinic/Group Practice 1557867843 Receives reassigned benefits from 4 practitioners
Practice locations: Savannah, GA

National Provider Directory

National Provider Directory

Member 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.

Verify at the official NPI Registry.