NPIMap

Organization Active NPI

Statewide Healthcare Inc.

  • Case Management Agency
  • Savannah, GA
National Provider Identifier
1982994307
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
STATEWIDE HEALTHCARE INC.
Practice address
102 Oglethorpe Professional CT
Suite 4
Savannah, GA 31406-3600
Phone
(912) 231-8958
Fax
(912) 234-7701
NPI assigned
Apr 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Authorized official

Name
Joseph C Gordon
Title
Chief Executive Officer
Phone
(912) 231-8958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

102 Oglethorpe Professional CT
Suite 4
Savannah, GA 31406-3600

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
123456789MedicaidSC

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.

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1982994307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 OGLETHORPE PROFESSIONAL CT",
            "address_2": "SUITE 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": "SUITE 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": "2011-04-19",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "912-231-8958"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123456789",
            "state": "SC"
        }
    ],
    "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 Apr 19, 2011; 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.