NPIMap

Organization Active NPI

Savannah Neurology Specialists P C

  • Neurology Physician
  • Savannah, GA
National Provider Identifier
1629203294
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
028560 Issued in GA
Legal business name
SAVANNAH NEUROLOGY SPECIALISTS P C
Practice address
6602 Waters Ave
Building C
Savannah, GA 31406-2716
Phone
(912) 354-7676
Fax
(912) 354-6040
NPI assigned
May 26, 2009
Last updated
Mar 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

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

Authorized official

Name
Joanne S Johansen
Title
C.O.O.
Phone
(912) 354-7676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 028560 GA Primary

Addresses

Primary practice location

6602 Waters Ave
Building C
Savannah, GA 31406-2716

Mailing address

6602 Waters Ave
Building C
Savannah, GA 31406-2716
Phone (912) 354-7676

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091016000328 GA Part B Supplier - Clinic/Group Practice 8224175641 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
Practice locations: Richmond Hill, GA; Savannah, GA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

917 Bypass 225 S
Greenwood, SC 29646
Phone (864) 227-5240

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1629203294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6602 WATERS AVE",
            "address_2": "BUILDING C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062716",
            "telephone_number": "912-354-7676",
            "fax_number": "912-354-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6602 WATERS AVE",
            "address_2": "BUILDING C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062716",
            "telephone_number": "912-354-7676",
            "fax_number": "912-354-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAVANNAH NEUROLOGY SPECIALISTS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "912-354-7676"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "028560",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 8, 2013; 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.