NPIMap

Organization Active NPI

Psychiatric Group of the Coastal Empire, Inc.

  • Psychiatry Physician
  • Savannah, GA
National Provider Identifier
1598855355
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHIATRIC GROUP OF THE COASTAL EMPIRE, INC.
Practice address
4700 Waters Ave
Savannah, GA 31404-6220
Phone
(912) 350-4905
Fax
(912) 350-4955
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Mrs. Robin J. Maddox
Title
Provider Enrollment Coordinator
Phone
(912) 350-9335

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4700 Waters Ave
Savannah, GA 31404-6220

Mailing address

PO Box 931979
Atlanta, GA 31193-1968
Phone (912) 350-4905

Other identifiers 1

IdentifierTypeStateIssuer
3000032168AMedicaidGA

National Provider Directory

National Provider Directory

Locations

4750 Waters Ave
Ste 212
Savannah, GA 31404
Phone (912) 350-5630

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1598855355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931979",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311931968",
            "telephone_number": "912-350-4905",
            "fax_number": "912-350-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-4905",
            "fax_number": "912-350-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC GROUP OF THE COASTAL EMPIRE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2008-01-15",
        "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",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000032168A",
            "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 Jan 15, 2008; 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.