Individual provider Active NPI

Glenn Soldan, AA

  • Anesthesiologist Assistant
  • Savannah, GA
National Provider Identifier
1659412575
Registry record updated Feb 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
004361 Issued in GA
Practice address
6605 Abercorn St
St 108
Savannah, GA 31405-5815
Phone
(912) 354-5357
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 004361 GA Primary
Physician Assistant 363A00000X 004361 GA

Addresses

Primary practice location

6605 Abercorn St
St 108
Savannah, GA 31405-5815

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone (800) 394-4445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040922000945 GA Practitioner - Anesthesiology Assistant 0749258267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Anesthesiology Associates of Georgia LLCGroup PAC ID 7618934779, 230 clinicians

Practice addresses (Care Compare)

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 819-4100

2701 N Decatur Rd
Decatur, GA 30033-5918
Phone (678) 514-1991

5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 819-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
004361GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Mar 16, 2016 Accepting new patients

Locations

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

247 S Main St
Reidsville, GA 30453
Phone (478) 787-6255

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

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207

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 2

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265760000000",
    "number": "1659412575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464",
            "telephone_number": "800-394-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 ABERCORN ST",
            "address_2": "ST 108",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055815",
            "telephone_number": "912-354-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLDAN",
        "first_name": "GLENN",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "004361",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004361",
            "primary": false
        }
    ],
    "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 Feb 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.