NPIMap

Organization Active NPI

Georgia Outreach, LLC

  • Psychiatry Physician
  • Savannah, GA
National Provider Identifier
1902128929
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
GEORGIA OUTREACH, LLC
Practice address
7130 Hodgson Memorial Dr Ste 101
Savannah, GA 31406-1527
Phone
(912) 355-3881
NPI assigned
Feb 17, 2010
Last updated
May 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Authorized official

Name
Ashley Richbourg, LCSWNPI 1770638264
Title
Director
Phone
(919) 452-3324

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

7130 Hodgson Memorial Dr Ste 101
Savannah, GA 31406-1527

Mailing address

7130 Hodgson Memorial Dr Ste 101
Savannah, GA 31406-1527
Phone (912) 355-3881

Other practice location 1

135 Goshen Road Ext Ste 203
Rincon, GA 31326-5569
Phone (912) 355-3881

Other practice location 2

131 Canal St Ste D
Pooler, GA 31322-6018
Phone (912) 988-3181

Other practice location 3

408 E Bolton St Ste C
Savannah, GA 31401-5920
Phone (912) 541-2397

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110425000693 GA Part B Supplier - Clinic/Group Practice 5193900777 Receives reassigned benefits from 5 practitioners
Practice locations: Savannah, GA

National Provider Directory

National Provider Directory

Locations

131 Canal St
Ste D
Pooler, GA 31322
Phone (912) 988-3181

408 E Bolton St
Ste C
Savannah, GA 31401
Phone (912) 541-2397

7130 Hodgson Memorial Dr
Ste 101
Savannah, GA 31406
Phone (912) 349-4495

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525219200000",
    "number": "1902128929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7130 HODGSON MEMORIAL DR STE 101",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061527",
            "telephone_number": "912-355-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7130 HODGSON MEMORIAL DR STE 101",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061527",
            "telephone_number": "912-355-3881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 Goshen Road Ext Ste 203",
            "address_purpose": "LOCATION",
            "city": "Rincon",
            "state": "GA",
            "postal_code": "313265569",
            "country_code": "US",
            "telephone_number": "912-355-3881",
            "fax_number": "912-335-3490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131 Canal St Ste D",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313226018",
            "country_code": "US",
            "telephone_number": "912-988-3181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "408 E Bolton St Ste C",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314015920",
            "country_code": "US",
            "telephone_number": "912-541-2397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEORGIA OUTREACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2018-05-02",
        "status": "A",
        "authorized_official_last_name": "RICHBOURG",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-452-3324",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; 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.