GLEN L. SCARBROUGH (NPI# 1164469177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164469177 |
| Entity Type | Individual |
| Full Name | GLEN L. SCARBROUGH |
| Credential | M.D. |
| Practice Address |
5353 Reynolds St Suite 300 Savannah GA 31405-6015 |
| Practice Telephone | 9123556005 |
| Practice Fax Number | 9123555643 |
| Mailing Telephone | 9123556005 |
| Mailing Fax Number | 9123555643 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2014-02-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 044329 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00878215A | 05 | |
| SC | GA1133 | 05 |
| Street Address |
5353 REYNOLDS ST SUITE 300 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405-6015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487657151 | Carolyn Kleeman Williams | Pharmacist | 5353 Reynolds St, Savannah, GA 31405-6015 | 2005-05-24 |
| 1851998017 | Elyssa Whitley | Anesthesiologist Assistant | 5353 Reynolds St, Savannah, GA 31405-6015 | 2020-10-01 |
| 1851905020 | Sherry Yvette Smith | Nurse Practitioner | 5353 Reynolds St, Savannah, GA 31405-6015 | 2020-09-03 |
| 1558970657 | Julia Ann Gainey | Anesthesiologist Assistant | 5353 Reynolds St, Savannah, GA 31405-6015 | 2020-07-24 |
| 1457973232 | Morgan E Fink | Dietitian, Registered | 5353 Reynolds St, Savannah, GA 31405-6015 | 2020-05-14 |
| 1750917563 | Catherine Morrison | Registered Nurse | 5353 Reynolds St, Savannah, GA 31405-6015 | 2020-03-13 |
| 1568006534 | Courtney Brue | Registered Nurse | 5353 Reynolds St, Savannah, GA 31405-6015 | 2019-11-03 |
| 1013561281 | Megan Boyd | Family Medicine | 5353 Reynolds St, Savannah, GA 31405-6015 | 2019-07-26 |
| 1760958979 | Virginia Claiborne Stuber | Anesthesiologist Assistant | 5353 Reynolds St, Savannah, GA 31405-6015 | 2018-10-16 |
| 1437633328 | Zachary Emanuel Madramootoo | Nurse Practitioner | 5353 Reynolds St, Savannah, GA 31405-6015 | 2018-09-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013257344 | Stephanie Denise Tootle | Obstetrics & Gynecology | 1004 Memorial Ln Ste 500, Savannah, GA 31410 | 2013-02-23 |
| 1033476692 | Jessica Miller Mullinix | Obstetrics & Gynecology | 5354 Reynolds St Ste 518, Savannah, GA 31405 | 2012-04-19 |
| 1194989426 | James D Smith Md PC | Obstetrics & Gynecology | 5354 Reynalds St, Suite 225, Savannah, GA 31405 | 2008-07-16 |
| 1427257484 | Lisa M Semple, Do PC | Obstetrics & Gynecology | 5353 Reynolds St Ste 201, Savannah, GA 31405-6087 | 2007-07-11 |
| 1730268046 | Michael Joseph Jackson | Obstetrics & Gynecology | 5311 Paulsen St, Savannah, GA 31405-4800 | 2006-11-06 |
| 1336225390 | James Anthony Carr | Obstetrics & Gynecology | 5204 Paulsen St, Savannah, GA 31405-4704 | 2006-10-31 |
| 1548358328 | Gregg Parker | Obstetrics & Gynecology | 910 E 70th St, Savannah, GA 31405-4815 | 2006-10-10 |
| 1972600021 | Ilan D Bornstein, M.d., L L C | Obstetrics & Gynecology | 4750 Waters Ave Ste 210, Savannah, GA 31404-6268 | 2006-09-20 |
| 1386740249 | Suresh I Persad-maharaj | Obstetrics & Gynecology | 361 B Commercial Dr., Savannah, GA 31406-3643 | 2006-09-16 |
| 1689779589 | Ashmed Vazquez | Obstetrics & Gynecology | 5354 Reynolds St Ste 304, Savannah, GA 31405-6010 | 2006-09-14 |
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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.