JOHN MICHAEL DEMICCO (NPI# 1285632125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285632125 |
| Entity Type | Individual |
| Full Name | JOHN MICHAEL DEMICCO |
| Credential | M.D. |
| Practice Address |
11700 Mercy Blvd Plaza D Suite A-1 Savannah GA 31419-1753 |
| Practice Telephone | 9129208898 |
| Practice Fax Number | 9129204418 |
| Mailing Telephone | 9129208898 |
| Mailing Fax Number | 9129204418 |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2010-07-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 016855 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | BLUECROSS BLUESHIELD | 145002 | 01 |
| SC | G16855 | 05 | |
| GA | 000586539C | 05 |
| Street Address |
11700 MERCY BLVD PLAZA D SUITE A-1 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31419-1753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215932066 | Cynthia Drown | Nurse Practitioner | 11700 Mercy Blvd, Plaza D Suite A, Savannah, GA 31419-1753 | 2005-06-17 |
| 1093205957 | Clint R. Fenton | Physician Assistant | 11700 Mercy Blvd, Plaza D #6, Savannah, GA 31419 | 2018-05-16 |
| 1568962967 | Ortho Sport & Spine Physicians Savannah | Clinic/Center | 11700 Mercy Blvd, Savannah, GA 31419-1753 | 2018-02-13 |
| 1982134003 | Mackenzie Grace Shelton | Physician Assistant | 11700 Mercy Blvd, Plaza D #6, Savannah, GA 31419 | 2017-06-13 |
| 1205383130 | Beverly J Lippert | Nurse Practitioner | 11700 Mercy Blvd, Plaza D #6, Savannah, GA 31419 | 2016-09-08 |
| 1487000519 | Angel Everidge | Physician Assistant | 11700 Mercy Blvd, Plaza D, #6, Savannah, GA 31419 | 2016-05-07 |
| 1629470273 | Ortho Sport & Spine Physicians Savannah | Orthopaedic Surgery | 11700 Mercy Blvd, Savannah, GA 31419-1753 | 2014-09-25 |
| 1568805505 | Andrew Robert Papoy | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11700 Mercy Blvd, Plaza D Bldg. 1 Suite A, Savannah, GA 31419 | 2013-04-09 |
| 1750635579 | St. Joseph's Medical Group, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11700 Mercy Blvd, Plaza D Suite A, Savannah, GA 31419 | 2012-10-31 |
| 1407119423 | Rebecca M Hart | Nurse Practitioner | 11700 Mercy Blvd, Bldg #5, Savannah, GA 31419-1753 | 2012-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932653 | Loving Hands Adult Care | Home Health Aide | 101 St. Goerge Blvd, 6t, Savannah, GA 31419 | 2020-11-03 |
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1699318139 | Jessica Kaitlyn Matthewson | Nurse Practitioner | 11700 Mercy Blvd Plaza D, Bldg #5, Savannah, GA 31419 | 2019-10-28 |
| 1679133219 | Rebecca Denise Brown-tuyishimire | Counselor | Savannah Outpatient Clinic, 1170 Shawnee Street, Savannah, GA 31419 | 2019-06-17 |
| 1356900856 | Julio Roberto Castellanos Jr. | Behavior Technician | 785 King George Blvd Ste 103, Savannah, GA 31419 | 2019-06-07 |
| 1669941761 | Paul-david Arthur Cooper | Peer Specialist | 117 Shawnee Street, Va Savannah Clinic, Savannah, GA 31419 | 2018-11-19 |
| 1326538521 | Jay Carter Jr. | Social Worker | 1170 Shawnee St., Savannah, GA 31419 | 2018-05-14 |
| 1245771070 | Emily Robertson | Nurse Practitioner | 11133 Abercorm Street, Suite 10, Savannah, GA 31419 | 2017-03-13 |
| 1760833750 | Cady-jo Steidle | Behavioral Analyst | 143 Sugar Mill Cir, Savannah, GA 31419 | 2016-06-30 |
| 1265881189 | Mallory Williams | Physician Assistant | 11909 D. Mcauley Drive, Savannah, GA 31419 | 2016-06-10 |
| Find all providers in zip 31419 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518351857 | R & R Fitness,llc | Internal Medicine | 400 Mall Blvd Ste C, Savannah, GA 31406-4873 | 2015-03-25 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1144516162 | Charles Adam Mccoy | Internal Medicine | 11700 Mercy Blvd Ste 5, Savannah, GA 31419-1753 | 2011-06-28 |
| 1114245529 | Elizabeth Sue Neufeld | Internal Medicine | 1 Castlebrook Retreat, Savannah, GA 31411 | 2010-05-10 |
| 1336466366 | Walter Bowden Jr. | Internal Medicine | 6510 Seawright Dr, Savannah, GA 31406-2752 | 2010-04-30 |
| 1922235548 | Frederick Debele Maner | Internal Medicine | 308 Bradley Point Rd, Savannah, GA 31410-3507 | 2009-06-22 |
| 1295969228 | Kurt Singh Kang | Internal Medicine | 101 W Mulberry Blvd Ste 100, Savannah, GA 31407 | 2009-05-05 |
| 1508017542 | Healthy Family PC | Internal Medicine | 705 E 65th St, Savannah, GA 31405-4408 | 2008-10-08 |
| 1851586747 | Georg Laemmerhirt | Internal Medicine | 800 E 68th St, Savannah, GA 31405-4710 | 2007-09-13 |
| 1487849253 | Ne Win | Internal Medicine | 4700 Waters Ave S, Mhumc Memorial Health Im Edu, Savannah, GA 31404 | 2007-09-13 |
| Find all providers in SAVANNAH | ||||
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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.