NPIMap

Organization Active NPI

Coastal Ambulatory Anesthesia LLC

  • Anesthesiology Physician
  • Savannah, GA
National Provider Identifier
1750753786
Registry record updated Jul 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
COASTAL AMBULATORY ANESTHESIA LLC
Practice address
1139 Lexington Ave
Savannah, GA 31404-5502
Phone
(912) 429-9020
Fax
(912) 352-0793
NPI assigned
Oct 29, 2015
Last updated
Jul 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2022

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

Authorized official

Name
Jung Suh, MDNPI 1952512105
Title
Chief Medical Officer
Phone
(404) 881-1094

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X GA Primary

Addresses

Primary practice location

1139 Lexington Ave
Savannah, GA 31404-5502

Mailing address

PO Box 16087
Savannah, GA 31416-2787
Phone (912) 429-9020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160107001775 GA Part B Supplier - Clinic/Group Practice 1052613023 Receives reassigned benefits from 462 practitioners
Practice locations: Woodstock, GA; Suwanee, GA; Atlanta, GA; Stockbridge, GA; Savannah, GA; Newnan, GA; Marietta, GA; Lithonia, GA…

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Aga, LLC

    dba Atlanta Gastroenterology Associates

    • Gastroenterology Physician
    • Atlanta, GA
    • NPI 1124064118

    Member Of

    NPD member

Locations

340 N Milledge Ave
Ste A
Athens, GA 30601
Phone (706) 548-0008

1955 Textile Way
Ste A
Gainesville, GA 30501
Phone (678) 987-1499

226 E College St
#A
Griffin, GA 30224
Phone (678) 987-1490

1200 Lower Fayetteville Rd
#A
Newnan, GA 30265
Phone (404) 881-1094

13040 Abercorn St
Savannah, GA 31419
Phone (912) 429-9020

Practitioners & affiliated clinicians

Practitioners 467

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 467

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658620800000",
    "number": "1750753786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16087",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314162787",
            "telephone_number": "912-429-9020",
            "fax_number": "912-352-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 LEXINGTON AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314045502",
            "telephone_number": "912-429-9020",
            "fax_number": "912-352-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL AMBULATORY ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2022-07-24",
        "certification_date": "2022-07-24",
        "status": "A",
        "authorized_official_last_name": "SUH",
        "authorized_official_first_name": "JUNG",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "404-881-1094",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": null,
            "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 Jul 24, 2022; 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.