NPIMap

Organization Active NPI

Ear, Nose, & Throat Associates of Savannah, PC

  • Otolaryngology Physician
  • Statesboro, GA
National Provider Identifier
1841445780
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR, NOSE, & THROAT ASSOCIATES OF SAVANNAH, PC
Practice address
16741 Highway 67 South
Suite G
Statesboro, GA 30458
Phone
(912) 351-3030
Fax
(912) 351-3039
NPI assigned
Nov 19, 2008
Last updated
Apr 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Authorized official

Name
Kathy Layne
Title
Office Manager
Phone
(912) 629-4535

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 008102 B 621111 GA
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

16741 Highway 67 South
Suite G
Statesboro, GA 30458

Mailing address

5201 Frederick Street
Savannah, GA 31405-4501
Phone (912) 351-3030

Other identifiers 2

IdentifierTypeStateIssuer
300034510AOtherGAMEDICAID PAYEE: SITE 1
300034510KOtherGAMEDICAID PAYEE: SITE 2

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000282 GA Part B Supplier - Clinic/Group Practice 8426030479 Receives reassigned benefits from 16 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pooler, GA; Savannah, GA; Statesboro, GA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ear Nose Throat Associates of Savannah PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270080000000",
    "number": "1841445780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 FREDERICK STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054501",
            "telephone_number": "912-351-3030",
            "fax_number": "912-351-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16741 HIGHWAY 67 SOUTH",
            "address_2": "SUITE G",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-351-3030",
            "fax_number": "912-351-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE, & THROAT ASSOCIATES OF SAVANNAH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-19",
        "last_updated": "2010-04-01",
        "status": "A",
        "authorized_official_last_name": "LAYNE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-629-4535"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "008102 B 621111",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PAYEE: SITE 1",
            "identifier": "300034510A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PAYEE: SITE 2",
            "identifier": "300034510K",
            "state": "GA"
        }
    ],
    "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 Apr 1, 2010; 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.

Verify at the official NPI Registry.