Gregory Shawn Felzien, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

23900 Issued in OK

Practice address

3 West Altman Street
Statesboro, GA 30458-5212

Phone

(912) 764-2402

Fax

(912) 764-5561

NPI assigned

Dec 5, 2005

Last updated

Mar 14, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Infectious DiseaseAlso: Internal Medicine

Education

University of Colorado School of Medicine, Denver, 1995

Medicare assignment

May accept Medicare assignment

Group practices

Positive Impact Health Centers IncGroup PAC ID 5496721987, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/6123adb2-d0d2-485a-9dcf-5fba87efb2ef/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Positive Impact Health Centers Inc

  • Primary Care Clinic/Center
  • Duluth, GA
  • NPI 1790861995
  Medicare reassignment Care Compare group NPD
• Bulloch County Board of Health

  dba Bulloch Wellness Center

  • Public Health or Welfare Agency
  • Statesboro, GA
  • NPI 1043243876
  Medicare reassignment NPD
• Coffee County Board of Health

  • Public Health or Welfare Agency
  • Douglas, GA
  • NPI 1952346074
  Medicare reassignment NPD
• Bulloch County Board of Health

  • Public Health or Welfare Agency
  • Statesboro, GA
  • NPI 1417985060
  NPD
• Coffee County Board of Health

  dba Coffee Wellness Center

  • Public Health or Welfare Agency
  • Douglas, GA
  • NPI 1316976699
  NPD
• Positive Impact Health Centers, Inc.

  dba PIHC Pharmacy

  • Community/Retail Pharmacy
  • Decatur, GA
  • NPI 1912476466
  NPD
• Candler County Board of Health

  • Public Health or Welfare Agency
  • Metter, GA
  • NPI 1649208216
  NPD (past)
• Positive Impact Health Centers, Inc

  • Case Management Agency
  • Duluth, GA
  • NPI 1619064847
  NPD (past)
• Ware County Board of Health

  • Public Health or Welfare Agency
  • Waycross, GA
  • NPI 1568491785
  NPD (past)
• Wayne County Board of Health

  • Public Health or Welfare Agency
  • Jesup, GA
  • NPI 1801825021
  NPD (past)

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1811971625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WEST ALTMAN STREET",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585212",
            "telephone_number": "912-764-2402",
            "fax_number": "912-764-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WEST ALTMAN STREET",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585212",
            "telephone_number": "912-764-2402",
            "fax_number": "912-764-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELZIEN",
        "first_name": "GREGORY",
        "middle_name": "SHAWN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "23900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152095001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200015000A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179537436E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "202I445780",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Foot Care of Statesboro
• Family Health Care Center, PC (Family Health Care Center)
• Family Podiatry Center PC
• Family Practice Dental Care of Statesboro
• Daniel M Feldman, M.D.
• Hannah Rae Fennell, RBT
• Joseph J Fennell II, LPC
• Becky Alli Fields
• Madison Leigh Fields, LPC
• Asia Victoria Finley

• Internal Medicine Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.