Active NPI
Supreme Internal Medicine, P.C.
- Primary Care Clinic/Center
- Statesboro, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- License
- 68726
- Legal business name
- SUPREME INTERNAL MEDICINE, P.C.
- Practice address
- 1207 Merchant Way
Suite 201
Statesboro, GA 30458-0861 - Phone
- (912) 243-9080
- Fax
- (912) 243-9084
- NPI assigned
- May 24, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Hamilton O Emokpae, M.D.
- Title
- Physician
- Phone
- (912) 243-9080
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 68726 | GA | Primary |
Addresses
Primary practice location
1207 Merchant Way
Suite 201
Statesboro, GA 30458-0861
Mailing address
1207 Merchant Way
Suite 201
Statesboro, GA 30458
Phone (912) 243-9080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Supreme Internal Medicine
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Internal Medicine Physician
- Statesboro, GA
- NPI 1891130647
Locations
1207 Merchant Way
#201B
Statesboro, GA 30458
Phone (912) 243-9080
1207 Merchant Way
Ste 201
Statesboro, GA 30458
Phone (912) 243-9080
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Statesboro, GA
- NPI 1215013354
-
- Physician Assistant
- New York, NY
- NPI 1417097635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369353600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1369353600000",
"number": "1831536341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1207 MERCHANT WAY",
"address_2": "SUITE 201",
"city": "STATESBORO",
"state": "GA",
"postal_code": "30458",
"telephone_number": "912-243-9080",
"fax_number": "912-243-9084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1207 MERCHANT WAY",
"address_2": "SUITE 201",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304580861",
"telephone_number": "912-243-9080",
"fax_number": "912-243-9084"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPREME INTERNAL MEDICINE, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2013-05-24",
"last_updated": "2013-05-24",
"status": "A",
"authorized_official_last_name": "EMOKPAE",
"authorized_official_first_name": "HAMILTON",
"authorized_official_middle_name": "O",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "912-243-9080",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "GA",
"license": "68726",
"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 May 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.