Organization Active NPI

Sandra L. Mager, M.D.P.C.

  • Obstetrics & Gynecology Physician
  • Jesup, GA
National Provider Identifier
1770839607
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
38043 Issued in GA
Legal business name
SANDRA L. MAGER, M.D.P.C.
Practice address
114 W. Cherry Street
Jesup, GA 31545
Phone
(912) 588-1020
Fax
(912) 588-1002
NPI assigned
Jul 30, 2012
Last updated
Mar 29, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Authorized official

Name
Sandra Mager, M.D.NPI 1912976846
Title
Physician
Phone
(912) 588-1020

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 38043 GA Primary

Addresses

Primary practice location

114 W. Cherry Street
Jesup, GA 31545

Mailing address

114 W. Cherry Street
Jesup, GA 31545
Phone (912) 588-1020

Other identifiers 1

IdentifierTypeStateIssuer
000619297BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120924000251 GA Part B Supplier - Clinic/Group Practice 9436307055 Receives reassigned benefits from 4 practitioners
Practice locations: Baxley, GA; Blackshear, GA; Jesup, GA

National Provider Directory

National Provider Directory

Locations

1007 S Macon St
Jesup, GA 31545
Phone (912) 427-4344

114 W Cherry St
Jesup, GA 31545
Phone (912) 588-1020

Practitioners & affiliated clinicians

Practitioners 7

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": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1770839607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W. CHERRY STREET",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "31545",
            "telephone_number": "912-588-1020",
            "fax_number": "912-588-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W. CHERRY STREET",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "31545",
            "telephone_number": "912-588-1020",
            "fax_number": "912-588-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA L. MAGER, M.D.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-30",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "MAGER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "912-588-1020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "38043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000619297B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.