NPIMap

Organization Active NPI

Michelle Zeanah MD PC

Doing business as Behavioral Pediatrics of Rural Georgia

  • Medical Specialty Clinic/Center
  • Statesboro, GA
National Provider Identifier
1760981609
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
56388 Issued in GA
Legal business name
MICHELLE ZEANAH MD PC
Doing business as
Behavioral Pediatrics of Rural Georgia
Practice address
406 Savannah Ave
Statesboro, GA 30458-5102
Phone
(912) 489-4379
Fax
(912) 681-4379
NPI assigned
Feb 6, 2018
Last updated
Dec 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Authorized official

Name
Dr. Michelle Reynolds Zeanah, MDNPI 1013931617
Title
Owner
Phone
(912) 489-4379

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)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 56388 GA Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

406 Savannah Ave
Statesboro, GA 30458-5102

Mailing address

406 Savannah Ave
Statesboro, GA 30458-5102
Phone (912) 489-4379

Other names 1

  • Behavioral Pediatrics of Rural Georgia Doing business as

National Provider Directory

National Provider Directory

Locations

406 Savannah Ave
Statesboro, GA 30458
Phone (912) 489-4379

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1760981609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 SAVANNAH AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585102",
            "telephone_number": "912-489-4379",
            "fax_number": "912-681-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 SAVANNAH AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585102",
            "telephone_number": "912-489-4379",
            "fax_number": "912-681-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE ZEANAH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-06",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "ZEANAH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "REYNOLDS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-489-4379",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "56388",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Pediatrics of Rural Georgia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.