Fresh Heads Savannah, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FRESH HEADS SAVANNAH, LLC

Practice address

1000 US Highway 80 W
Pooler, GA 31322-2114

Phone

(912) 559-4011

NPI assigned

Apr 4, 2019

Last updated

Apr 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Whitney Manda Ottesen

Title

Owner

Phone

(904) 235-3157

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1811459258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 LAKE STONE CIR",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824342",
            "telephone_number": "904-235-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 US HIGHWAY 80 W",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222114",
            "telephone_number": "912-559-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH HEADS SAVANNAH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "OTTESEN",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_middle_name": "MANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-235-3157",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Roxanne Fort
• Austin Fortner, DC
• Jeremy Kyle Frankum, DPT
• Taylor Frazier, MD
• Kristal Rene Freeman, LPC
• Victoria Lynn Freyermuth
• Jasmine Fuller
• Skylar Fuller
• Ga Doctors of Optometry LLC
• Ga Foot and Ankle Institute

• Clinic/Center in Pooler, GA
• Providers in Pooler, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.