Organization Active NPI

Savannah State University

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1770901019
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAVANNAH STATE UNIVERSITY
Doing business as
SSU Harris-McDew Student Health Center
Practice address
5050 Spring Valley Rd
Dallas, TX 75244-3995
Phone
(972) 367-4845
Fax
(972) 367-3451
NPI assigned
Apr 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Authorized official

Name
Joseph Steffen
Title
University Counsel
Phone
(912) 358-4057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5050 Spring Valley Rd
Dallas, TX 75244-3995

Mailing address

3219 College St
Box 20524
Savannah, GA 31404-5254
Phone (912) 358-4122

Other names 1

  • SSU Harris-McDew Student Health Center Doing business as

National Provider Directory

National Provider Directory

Locations

3219 College St
#20524
Savannah, GA 31404

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1770901019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3219 COLLEGE ST",
            "address_2": "BOX 20524",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314045254",
            "telephone_number": "912-358-4122",
            "fax_number": "912-358-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SPRING VALLEY RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443995",
            "telephone_number": "972-367-4845",
            "fax_number": "972-367-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAVANNAH STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "STEFFEN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "UNIVERSITY COUNSEL",
        "authorized_official_telephone_number": "912-358-4057"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSU Harris-McDew Student Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.