Organization Active NPI

East Georgia Womens Center

  • Obstetrics & Gynecology Physician
  • Statesboro, GA
National Provider Identifier
1801007695
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
03658 Issued in GA
Legal business name
EAST GEORGIA WOMENS CENTER
Practice address
1012 Bermuda Run
Statesboro, GA 30458-0858
Phone
(912) 871-4800
Fax
(912) 871-4900
NPI assigned
May 24, 2007
Last updated
Jul 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Ginger Deloach
Title
Insurance & Billing
Phone
(912) 871-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 03658 GA Primary

Addresses

Primary practice location

1012 Bermuda Run
Statesboro, GA 30458-0858

Mailing address

PO Box 428
Statesboro, GA 30459-0428
Phone (912) 871-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051206000946 GA Part B Supplier - Clinic/Group Practice 4486674322 Receives reassigned benefits from 2 practitioners
Practice locations: Statesboro, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0976282East Georgia Womens Center1012 Bermuda Run Road, Statesboro, GA 30458Provider-performed microscopyJul 30, 2026

National Provider Directory

National Provider Directory

Locations

1012 Bermuda Run
Statesboro, GA 30458
Phone (912) 871-4800

2 Ed Moore Ct
#C
Statesboro, GA 30458
Phone (912) 871-4800

Practitioners & affiliated clinicians

Practitioners 4

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": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1801007695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304590428",
            "telephone_number": "912-871-4800",
            "fax_number": "912-871-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 BERMUDA RUN",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580858",
            "telephone_number": "912-871-4800",
            "fax_number": "912-871-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST GEORGIA WOMENS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "DELOACH",
        "authorized_official_first_name": "GINGER",
        "authorized_official_title_or_position": "INSURANCE & BILLING",
        "authorized_official_telephone_number": "912-871-4800"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "03658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.