NPIMap

Organization Active NPI

Pediatric Associates of Savannah, P.C.

  • Pediatrics Physician
  • Savannah, GA
National Provider Identifier
1508850231
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES OF SAVANNAH, P.C.
Practice address
4600 Waters Ave
Suite 100
Savannah, GA 31404-6702
Phone
(912) 355-2462
Fax
(912) 353-1836
NPI assigned
Sep 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Mrs. Libby Staggs
Title
Office Manager
Phone
(912) 355-2462

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

4600 Waters Ave
Suite 100
Savannah, GA 31404-6702

Mailing address

4600 Waters Ave
Suite 100
Savannah, GA 31404-6702
Phone (912) 355-2462

Other identifiers 1

IdentifierTypeStateIssuer
085001460GMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Associates of Savann2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4600 Waters Ave
Ste 100
Savannah, GA 31404
Phone (912) 353-1830

7906 Highway 80 E
Savannah, GA 31410
Phone (912) 897-3677

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1508850231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 WATERS AVE",
            "address_2": "SUITE 100",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046702",
            "telephone_number": "912-355-2462",
            "fax_number": "912-353-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 WATERS AVE",
            "address_2": "SUITE 100",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046702",
            "telephone_number": "912-355-2462",
            "fax_number": "912-353-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF SAVANNAH, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "STAGGS",
        "authorized_official_first_name": "LIBBY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-355-2462",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085001460G",
            "state": "GA"
        }
    ],
    "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 Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.