NPIMap

Organization Active NPI

Augusta Addiction Associates

Doing business as Medmark Treatment Centers Savannah

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Savannah, GA
National Provider Identifier
1972880417
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
AUGUSTA ADDICTION ASSOCIATES
Doing business as
Medmark Treatment Centers Savannah
Practice address
600 Commercial CT
Suite a
Savannah, GA 31406-3674
Phone
(912) 352-4357
Fax
(912) 352-4395
NPI assigned
Nov 11, 2011
Last updated
Jul 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDMARK ATREATMENT CENTERS OF GEORGIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X GA10135-M GA
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

600 Commercial CT
Suite a
Savannah, GA 31406-3674

Mailing address

1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300

Other identifiers 1

IdentifierTypeStateIssuer
NTP001069OtherGAOTP LICENSE

Other names 1

  • Medmark Treatment Centers Savannah Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200107003524 GA Part B Supplier - Opioid Treatment Program (Otp) 4688008261 Practice locations: Savannah, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2033823Augusta Addiction Associates, LLC600 Commercial Court, Suite a, Savannah, GA 31406Certificate of waiverDec 11, 2027

National Provider Directory

National Provider Directory
Part of
Medmark Treatment Centers

Locations

600 Commercial Ct
Ste A
Savannah, GA 31406
Phone (912) 352-4357

Practitioners & affiliated clinicians

Practitioners 8

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": "1320969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1972880417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300",
            "fax_number": "148-539-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COMMERCIAL CT",
            "address_2": "SUITE A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063674",
            "telephone_number": "912-352-4357",
            "fax_number": "912-352-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTA ADDICTION ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDMARK ATREATMENT CENTERS OF GEORGIA",
        "enumeration_date": "2011-11-11",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "GA",
            "license": "GA10135-M",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTP LICENSE",
            "identifier": "NTP001069",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medmark Treatment Centers Savannah",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medmark Treatment Centers Savannah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.