Active NPI
Steven James Pangborn, DPM
- Podiatrist
- Savannah, GA
National Provider Identifier
1669413977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- PO2210
- Practice address
- 1170 Shawnee St
Savannah, GA 31419-1618 - Phone
- (912) 920-0214
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | PO2210 | FL | Primary |
Addresses
Primary practice location
1170 Shawnee St
Savannah, GA 31419-1618
Mailing address
1170 Shawnee St
Savannah, GA 31419-1618
Phone (912) 920-0214
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 056234300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2210 | LA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484697600000",
"number": "1669413977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1170 SHAWNEE ST",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314191618",
"telephone_number": "912-920-0214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1170 SHAWNEE ST",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314191618",
"telephone_number": "912-920-0214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANGBORN",
"first_name": "STEVEN",
"middle_name": "JAMES",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2017-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "FL",
"license": "PO2210",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "056234300",
"state": "FL"
}
],
"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 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.