NPIMap

Individual provider Active NPI

Melanie Mooney, M.D.

  • Family Medicine Physician
  • Rincon, GA
National Provider Identifier
1861462970
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39861 Issued in SC
Practice address
423 S Columbia Ave
Rincon, GA 31326
Phone
(912) 826-8860
Fax
(912) 826-2813
NPI assigned
Jan 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39861 SC Primary

Addresses

Primary practice location

423 S Columbia Ave
Rincon, GA 31326

Mailing address

602 E 72ND St
Savannah, GA 31405-4913
Phone (912) 819-7878

Other identifiers 2

IdentifierTypeStateIssuer
64065360MedicaidSC
64065360MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160823002398 SC Practitioner - Family Practice 1759369747 Reassigns benefits to 1 organization
I20180702000426 GA Practitioner - Family Practice 1759369747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SJC Medical Group IncGroup PAC ID 7719978105, 57 clinicians

Practice addresses (Care Compare)

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 819-4949

423 S Columbia Ave
Rincon, GA 31326-9080
Phone (912) 826-8860

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39861SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJC Medical Group Inc Family Medicine CurrentSince Jun 4, 2018 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Aug 15, 2016 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Aug 15, 2016 Accepting new patients
Community Emergency Physicians, PLLC Past Accepting new patients

Locations

423 S Columbia Ave
Rincon, GA 31326
Phone (912) 826-2944

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

310 Eisenhower Dr
Ste 7A
Savannah, GA 31406
Phone (912) 355-6503

602 E 72nd St
Savannah, GA 31405
Phone (912) 819-7800

1680 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-7600

Interoperability endpoints

  • Direct secure messaging: drmooney@direct.sjchs.org
  • Direct secure messaging: melanie.mooney@sjcmg.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1861462970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 E 72ND ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054913",
            "telephone_number": "912-819-7878",
            "fax_number": "912-819-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 S COLUMBIA AVE",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "31326",
            "telephone_number": "912-826-8860",
            "fax_number": "912-826-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "MELANIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "39861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64065360",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64065360",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

Verify at the official NPI Registry.