NPIMap

Organization Active NPI

Renewalmd Statesboro

  • Plastic Surgery Physician
  • Statesboro, GA
National Provider Identifier
1952599730
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
51685 Issued in GA
Legal business name
RENEWALMD STATESBORO
Practice address
1209 Merchant Way
Suite 301
Statesboro, GA 30458
Phone
(912) 920-2090
Fax
(912) 920-7921
NPI assigned
Oct 5, 2007
Last updated
May 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Authorized official

Name
Barbara Keel, CPC, CPB, CPRC
Title
Patient Account Manager
Phone
(912) 920-5624

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 48571 GA
Plastic Surgery Physician 208200000X 51685 GA Primary
Plastic Surgery Physician 208200000X 45759 GA

Addresses

Primary practice location

1209 Merchant Way
Suite 301
Statesboro, GA 30458

Mailing address

900 Mohawk Street
Suite a
Savannah, GA 31419-1780
Phone (912) 920-5624

Other names 1

  • CEPS Statesboro Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Coastal Empire Plastic4 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.

Locations

1209 Merchant Way
Ste 301
Statesboro, GA 30458
Phone (912) 681-7993

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1952599730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MOHAWK STREET",
            "address_2": "SUITE A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191780",
            "telephone_number": "912-920-5624",
            "fax_number": "912-920-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 MERCHANT WAY",
            "address_2": "SUITE 301",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-920-2090",
            "fax_number": "912-920-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWALMD STATESBORO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "KEEL",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "PATIENT ACCOUNT MANAGER",
        "authorized_official_telephone_number": "912-920-5624",
        "authorized_official_credential": "CPC, CPB, CPRC"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "48571",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "51685",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "45759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CEPS Statesboro",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CEPS Statesboro",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 31, 2018; 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.