Individual provider Active NPI

Frederick Harold, DO

  • Family Medicine Physician
  • Savannah, GA
National Provider Identifier
1629484902
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
80159 Issued in GA
Practice address
527 Eisenhower Drive
Savannah, GA 31406
Phone
(912) 819-9100
Fax
(912) 819-9101
NPI assigned
Jul 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.012118 OH
Family Medicine Physician 207Q00000X 80159 GA Primary

Addresses

Primary practice location

527 Eisenhower Drive
Savannah, GA 31406

Mailing address

836 E. 65TH Street
Suite 22
Savannah, GA 31405
Phone (912) 819-7878

Other identifiers 1

IdentifierTypeStateIssuer
003207605AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180907002637 GA Practitioner - Family Practice 9638492341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SJC Medical Group IncGroup PAC ID 7719978105, 57 clinicians

Practice addresses (Care Compare)

10055 Ford Ave
Suite 3a
Richmond Hill, GA 31324-3972
Phone (912) 819-9601

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 819-4949

527 Eisenhower Dr
Savannah, GA 31406-2668
Phone (912) 819-9100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
80159GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJC Medical Group Inc Family Medicine CurrentSince Jul 1, 2018 Accepting new patients

Locations

10055 Ford Ave
Ste 3A
Richmond Hill, GA 31324
Phone (912) 355-5593

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

836 E 65th St
Ste 22
Savannah, GA 31405
Phone (912) 819-7878

602 E 72nd St
Savannah, GA 31405
Phone (912) 819-7800

527 Eisenhower Dr
Savannah, GA 31406
Phone (912) 443-4200

Interoperability endpoints

  • Direct secure messaging: drharoldf@direct.sjchs.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1629484902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E. 65TH STREET",
            "address_2": "SUITE 22",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-819-7878",
            "fax_number": "912-819-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 EISENHOWER DRIVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31406",
            "telephone_number": "912-819-9100",
            "fax_number": "912-819-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAROLD",
        "first_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.012118",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "80159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003207605A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.