Individual provider Active NPI

Michael B Sabom, M.D.

  • Cardiovascular Disease Physician
  • Blairsville, GA
National Provider Identifier
1821198557
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
022632 Issued in GA
Practice address
77 Weaver Road
Suite B
Blairsville, GA 30512-3136
Phone
(706) 835-1914
Fax
(706) 835-1920
NPI assigned
Sep 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 022632 GA Primary

Addresses

Primary practice location

77 Weaver Road
Suite B
Blairsville, GA 30512-3136

Mailing address

77 Weaver Road
Suite B
Blairsville, GA 30512-3136
Phone (706) 835-1914

Other identifiers 1

IdentifierTypeStateIssuer
000275217FIJHMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070117000200 GA Practitioner - Cardiovascular Disease (Cardiology) 1052312139 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc Cardiovascular Disease CurrentSince Oct 1, 2011 Accepting new patients
Northeast Georgia Heart Center Cardiovascular Disease Current Accepting new patients
Wendy L Smith M.D. PC Past Accepting new patients

Locations

77 Weaver Rd
#B
Blairsville, GA 30512
Phone (706) 439-6165

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

200 S Enota Dr NE
Ste 200
Gainesville, GA 30501
Phone (770) 534-0991

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1821198557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WEAVER ROAD",
            "address_2": "SUITE B",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123136",
            "telephone_number": "706-835-1914",
            "fax_number": "706-835-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WEAVER ROAD",
            "address_2": "SUITE B",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123136",
            "telephone_number": "706-835-1914",
            "fax_number": "706-835-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABOM",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "022632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000275217FIJH",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

Verify at the official NPI Registry.