ANDREW L. PENDLETON (NPI# 1114987757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114987757 |
| Entity Type | Individual |
| Full Name | ANDREW L. PENDLETON |
| Credential | MD |
| Practice Address |
4750 Waters Ave Ste 103 Savannah GA 31404-6267 |
| Practice Telephone | 9123505646 |
| Practice Fax Number | 9123505697 |
| Mailing Telephone | 9123505646 |
| Mailing Fax Number | 9123505697 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2018-08-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
067429 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RAILROAD MEDICARE | P01059892 | 01 |
| GA | 003122073B | 05 | |
| GA | 003122073C | 05 | |
| SC | GA1313 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4700 Waters Ave, Savannah, GA 314046220 | 9123508180 | 9123505697 |
| Street Address |
4750 WATERS AVE STE 103 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404-6267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346485000 | Ashley Clack Eason | Pediatrics | 4750 Waters Ave Ste 103, Savannah, GA 31404-6267 | 2008-12-10 |
| 1720177082 | John Parrott Whittle Jr. | Pediatrics | 4750 Waters Ave Ste 103, Savannah, GA 31404-6267 | 2006-10-12 |
| 1427076454 | Evangeline Joy Brown | Pediatrics | 4750 Waters Ave Ste 103, Savannah, GA 31404-6267 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864580 | Carli A Boatright | Registered Nurse | 4750 Waters Ave Suite 206, Savannah, GA 31404 | 2019-08-01 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| 1336503291 | Miles Love | Student in an Organized Health Care Education/Training Program | 1250 East 66th Street, Savannah, GA 31404 | 2016-04-07 |
| 1134536881 | David Patch | Specialist/Technologist | Pediatric Residency Program, Memorial University, Medical Center 4700 Waters Avenue, Savannah, GA 31404 | 2014-07-15 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1730446394 | Joshua Ryan Fann | Prosthetist | 3840 Waters Ave, Savannah, GA 31404 | 2012-04-19 |
| Find all providers in zip 31404 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639682420 | Savannah Pediatric Specialists, LLC | Pediatrics | 5102 Paulsen St Bldg 3, Savannah, GA 31405-4614 | 2017-11-15 |
| 1497782049 | Cynthia Gonzales | Pediatrics | 4700 Wates Ave, Savannah, GA 31404 | 2006-06-27 |
| 1124532817 | Savannah Pediatric Care, LLC | Pediatrics | 5102 Paulsen St Bldg 3, Savannah, GA 31405-4614 | 2017-11-17 |
| 1720177082 | John Parrott Whittle Jr. | Pediatrics | 4750 Waters Ave Ste 103, Savannah, GA 31404-6267 | 2006-10-12 |
| 1427076454 | Evangeline Joy Brown | Pediatrics | 4750 Waters Ave Ste 103, Savannah, GA 31404-6267 | 2006-07-17 |
| 1306874573 | Lawrence S Frankel | Pediatrics | 4700 Waters Ave, Savannah, GA 31404-6220 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518386853 | Rafi Kazi | Pediatrics | 5461 Meridian Mark Rd, Atlanta, GA 30342-3007 | 2014-04-15 |
| 1871936823 | Michael Hugh White | Pediatrics | 5461 Meridian Mark Road Ne, Suite 400, Atlanta, GA 30342 | 2013-04-09 |
| 1568624351 | Gary M Woods | Pediatrics | 5455 Meridian Marks Rd Ste 400, Atlanta, GA 30342 | 2008-07-02 |
| 1295993087 | Karen Elizabeth Effinger | Pediatrics | 2015 Uppergate Dr Fl 4, Atlanta, GA 30322-2200 | 2008-05-28 |
| 1922265826 | Perimeter Pediatrics | Pediatrics | 3020 Mercer University Drive, Ste 100, Chamblee, GA 30341-4145 | 2008-05-19 |
| 1255453759 | Theodore Samuel Johnson | Pediatrics | 1120 Fifteenth Street, Cn-4141a, Augusta, GA 30912 | 2007-04-04 |
| 1710041587 | Mppg, Inc. | Pediatrics | 512b South Main Street, Hinesville, GA 31313 | 2006-12-19 |
| 1053492975 | Vishwas S Sakhalkar | Pediatrics | 770 Pine St Ste 520, Macon, GA 31201-7567 | 2006-10-18 |
| 1114007549 | Robert Craig Castellino | Pediatrics | 14015 Clifton Rd, Atlanta, GA 30322-0001 | 2006-10-17 |
| 1295799161 | Glen Lew | Pediatrics | 5455 Meridian Mark Rd, Suite 400, Atlanta, GA 30342-1654 | 2006-04-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.