Active NPI
Savannah Health Group LLC
- Gerontology Nurse Practitioner
- Salt Lake City, UT
National Provider Identifier
1750875183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- Legal business name
- SAVANNAH HEALTH GROUP LLC
- Practice address
- 4035 S 500 E
Salt Lake City, UT 84107-1866 - Phone
- (801) 262-9181
- Fax
- (813) 336-8463
- NPI assigned
- Jun 19, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Edwin O Awinda, APRN
- Title
- Sole Member
- Phone
- (801) 941-4034
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | |||
| Gerontology Nurse Practitioner | 363LG0600X | Primary |
Addresses
Primary practice location
4035 S 500 E
Salt Lake City, UT 84107-1866
Mailing address
1728 S Wright CT
Salt Lake City, UT 84105-2914
Phone (801) 941-4034
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gerontology Nurse Practitioner
- Murray, UT
- NPI 1194216895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529366400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1601596800000",
"number": "1750875183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1728 S WRIGHT CT",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841052914",
"telephone_number": "801-941-4034",
"fax_number": "813-336-8463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4035 S 500 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841071866",
"telephone_number": "801-262-9181",
"fax_number": "813-336-8463"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAVANNAH HEALTH GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-06-19",
"last_updated": "2020-10-02",
"certification_date": "2020-10-02",
"status": "A",
"authorized_official_last_name": "AWINDA",
"authorized_official_first_name": "EDWIN",
"authorized_official_middle_name": "O",
"authorized_official_title_or_position": "SOLE MEMBER",
"authorized_official_telephone_number": "801-941-4034",
"authorized_official_credential": "APRN"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Gerontology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.