Individual provider Active NPI

Darron S Standiford, PA

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1689966608
Registry record updated Feb 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006105 Issued in GA
Practice address
5354 Reynolds St Ste 102
Savannah, GA 31405-6008
Phone
(912) 819-0500
Fax
(912) 819-0501
NPI assigned
May 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006105 GA Primary

Addresses

Primary practice location

5354 Reynolds St Ste 102
Savannah, GA 31405-6008

Mailing address

602 E 72ND St
Savannah, GA 31405-4913
Phone (912) 819-7878

Other identifiers 1

IdentifierTypeStateIssuer
6105OtherGAGEORGIA MEDICAL LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110701000101 GA Practitioner - Physician Assistant 4082892518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group LLCGroup PAC ID 6204089352, 9 clinicians

Practice addresses (Care Compare)

11700 Mercy Blvd
Savannah, GA 31419-1753
Phone (912) 819-0500

11705 Mercy Blvd
Savannah, GA 31419-1711

5354 Reynolds St
Suite 102
Savannah, GA 31405-6008
Phone (912) 819-0500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1671SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Urgentone, Inc. Physician Assistant Past Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients
Optim Orthopedics, LLC PastSince Oct 6, 2019 Accepting new patients
Memorial Health Urgentone, Inc. Physician Assistant Past Accepting new patients

Interoperability endpoints

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

Organizations & group practices 6

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": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518652800000",
    "number": "1689966608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 E 72ND ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054913",
            "telephone_number": "912-819-7878",
            "fax_number": "912-819-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 REYNOLDS ST STE 102",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056008",
            "telephone_number": "912-819-0500",
            "fax_number": "912-819-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDIFORD",
        "first_name": "DARRON",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2018-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA MEDICAL LICENSE",
            "identifier": "6105",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.