NPIMap

Organization Active NPI

Statewide Healthcare Inc

  • Home Health Agency
  • Savannah, GA
National Provider Identifier
1902159429
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
621610 Issued in GA
Legal business name
STATEWIDE HEALTHCARE INC
Practice address
102 Oglethorpe Professional CT
4
Savannah, GA 31406-3600
Phone
(912) 231-8958
Fax
(912) 234-7701
NPI assigned
Oct 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Authorized official

Name
Joseph C Gordon
Title
Ceo
Phone
(912) 231-8958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 621610 GA Primary

Addresses

Primary practice location

102 Oglethorpe Professional CT
4
Savannah, GA 31406-3600

Mailing address

102 Oglethorpe Professional CT
4
Savannah, GA 31406-3600
Phone (912) 231-8958

Other identifiers 1

IdentifierTypeStateIssuer
000510243CMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Statewide Healthcare Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

102 Oglethorpe Professional Ct
Ste 4
Savannah, GA 31406
Phone (912) 231-8958

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1902159429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 OGLETHORPE PROFESSIONAL CT",
            "address_2": "4",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063600",
            "telephone_number": "912-231-8958",
            "fax_number": "912-234-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 OGLETHORPE PROFESSIONAL CT",
            "address_2": "4",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063600",
            "telephone_number": "912-231-8958",
            "fax_number": "912-234-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEWIDE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-231-8958"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "621610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000510243C",
            "state": "GA"
        }
    ],
    "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 Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.