SOUTHCOAST MEDICAL GROUP, LLC (NPI# 1467451922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467451922 |
| Entity Type | Organization |
| Organization Name | SOUTHCOAST MEDICAL GROUP, LLC |
| Practice Address |
330 Benefield Dr Savannah GA 31406-2604 |
| Mailing Address |
Po Box 15849 Savannah GA 31416-2549 |
| Practice Telephone | 9123033552 |
| Practice Fax Number | 9123033506 |
| Mailing Telephone | 9123033552 |
| Mailing Fax Number | 9123033506 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2011-11-07 |
| Authorized Official Name | MR. JOHN MARRERO (ADMINISTRATOR) |
| Authorized Official Telephone | 9123033552 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
064752 | GA | Allopathic & Osteopathic Physicians |
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
047425 | GA | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 022482 | GA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 021614 | GA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | ========= | GA | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
========= | GA | Allopathic & Osteopathic Physicians |
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
========= | GA | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
========= | GA | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | ========= | GA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | ========= | GA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
========= | GA | Allopathic & Osteopathic Physicians |
| N | 225100000X | Physical Therapist | ========= | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 363A00000X | Physician Assistant | ========= | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | ========= | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | ========= | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GPA3131 | 05 | |
| FL | 909802000 | 05 | |
| SC | GPA643 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861745119 | Southcoast Medical Group, LLC | Family Medicine | 1326 Eisenhower Dr, Savannah, GA 31406-3928 | 2012-10-24 |
| 1881947802 | Southcoast Medical Group, LLC | Internal Medicine | 3780 Us Highway 17, Richmond Hill, GA 31324-3378 | 2012-10-16 |
| Street Address |
330 BENEFIELD DR |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31406-2604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324042 | Magnolia Home Health, LLC Dba Home Instead Senior Care | Homemaker | 6709 Forest Park Drive, Suite B, Savannah, GA 31406 | 2020-04-08 |
| 1831737949 | Sumona Mitchell | Specialist | 1100 Eisenhower Drive 15, Suite 7, Savannah, GA 31406 | 2019-12-19 |
| 1295373090 | Gateway Behavioral Health Services | Community/Behavioral Health | 2121 East Derenne Ave, Savannah, GA 31406 | 2019-12-12 |
| 1114578820 | Kenya Burns | Technician | 6 Castle Ct, Savannah, GA 31406 | 2019-09-24 |
| 1841755287 | Southside Emergency Dental Center LLC | Dentist | 10515 White Bluff Rd., Savannah, GA 31406 | 2019-02-08 |
| 1639651003 | Rachael Putman | Physical Therapist | 37 W Fairmont Ave Suite 323, Savannah, GA 31406 | 2018-09-03 |
| 1417439852 | Happy Kids Therapies, LLC | Physical Therapist | 37 W. Fairmont Avenue Suite 102, Savannah, GA 31406 | 2018-09-01 |
| 1487146619 | Georgia Occmed LLC | Clinic/Center | 310 Eisenhower Dr Bldg 12 Ste C, Savannah, GA 31406 | 2018-06-04 |
| 1023517505 | Antioch Vascular Center, LLC | Surgery | 9104 Middleground Road, Suite 2, Savannah, GA 31406 | 2018-02-09 |
| 1518496116 | Janay C Russell | Counselor | 6711 Forest Park Drive, Savannah, GA 31406 | 2017-06-07 |
| Find all providers in zip 31406 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871192260 | Ashley Willingham | Family Medicine | 210 Carlisle Way, Savannah, GA 31419-6606 | 2020-10-18 |
| 1881200772 | My Nurse Now, LLC | Family Medicine | 7070 Hodgson Memorial Dr, Savannah, GA 31406-2529 | 2020-09-16 |
| 1164052189 | Privia Medical Group of Georgia LLC | Family Medicine | 340 Eisenhower Dr Ste 1200, Savannah, GA 31406-2675 | 2020-01-17 |
| 1093289431 | Mosaic Medical Center - Maryville | Family Medicine | 301 E Price Ave Ste A, Savannah, MO 64485-2482 | 2019-01-18 |
| 1841769718 | Regenerative Healthcare, LLC | Family Medicine | 329 Eisenhower Dr Ste D, Savannah, GA 31406-2695 | 2018-11-20 |
| 1588105142 | Hamzah Telemed, LLC | Family Medicine | 35 Barnard St Ste 300, Savannah, GA 31401-2515 | 2017-03-16 |
| 1033598479 | Erica Blaikie Young | Family Medicine | 51 Johnny Mercer Blvd. Cottage A-1, Savannah, GA 31410 | 2015-05-19 |
| 1770989048 | Global Health Delivery, Inc. | Family Medicine | 361 Commercial Dr Ste B, Savannah, GA 31406-3643 | 2014-11-13 |
| 1215273123 | John Marion Fillingim | Family Medicine | 716 E 52nd St, Savannah, GA 31405-3604 | 2012-12-20 |
| 1619236205 | David Medical Enterprises | Family Medicine | 3840 Waters Avenue, I Care Family Medicine Clinic, Savannah, GA 31404-6264 | 2012-05-16 |
| 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.