SAVANNAH DIAGNOSTIC ASSOC PC (NPI# 1548267438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548267438 |
| Entity Type | Organization |
| Organization Name | SAVANNAH DIAGNOSTIC ASSOC PC |
| Practice Address |
12345 Mercy Blvd Savannah GA 31419-3436 |
| Practice Telephone | 9129273048 |
| Practice Fax Number | 9129250597 |
| Mailing Telephone | 9129273048 |
| Mailing Fax Number | 9129250597 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2010-07-19 |
| Authorized Official Name | DR. JOHN DAVID NORTHUP (PRESIDENT) |
| Authorized Official Telephone | 9129273046 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 016651 | GA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000018092A | 05 | |
| GA | BLUE CROSS BLUE SHIELD | 52241377 | 01 |
| Street Address |
12345 MERCY BLVD |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31419-3436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760046452 | Dannyel Smith | Nurse Practitioner | 12345 Mercy Blvd, Savannah, GA 31419-3436 | 2019-04-28 |
| 1518466556 | Katherine Ireland Klick | Nurse Practitioner | 12345 Mercy Blvd, Savannah, GA 31419-3436 | 2018-02-05 |
| 1700308509 | Tiffany Lee Boulanger | Nurse Practitioner | 12345 Mercy Blvd, Savannah, GA 31419-3436 | 2017-07-13 |
| 1023232527 | John David Northup | Internal Medicine | 12345 Mercy Blvd, Savannah, GA 31419-3436 | 2007-04-13 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245740745 | Shannon Stafford | Specialist | 8408 Marcus Pl Ste A, Savannah, GA 31406-4928 | 2017-10-10 |
| 1942749783 | Latasha Wright | Specialist | 104 Whitehaven Rd, Savannah, GA 31407-4809 | 2017-02-13 |
| 1487010484 | Rose Marie Spann | Specialist | 835 E 65th St Ste 102, Savannah, GA 31405-4430 | 2016-01-06 |
| 1396164976 | Tiana Rabusin | Specialist | 100 Bull St Ste 200, Savannah, GA 31401-3305 | 2014-04-10 |
| 1437586716 | Merit Independent Physician Association LLC | Specialist | 413 W Montgomery Cross Rd Ste 602, Savannah, GA 31406-3396 | 2013-10-02 |
| 1801235338 | Tanisha Thompson | Specialist | 13051 Abercorn St Ste B1, Savannah, GA 31419-1971 | 2013-06-18 |
| 1417216250 | Georgia Southern Office Solutions | Specialist | 9 Franklin Creek Rd S, Savannah, GA 31411-2825 | 2012-05-14 |
| 1790086338 | Armando Gonzalez Sanchez | Specialist | 1699 Chatham Pkwy Apt 617b, Savannah, GA 31405-7609 | 2010-11-13 |
| 1417271297 | Anna M Bowers | Specialist | 12052 Middleground Rd, Suite A, Savannah, GA 31419-1686 | 2010-03-23 |
| 1083878920 | Cossio Pediatrics LLC | Specialist | 334 Stephenson Ave, Savannah, GA 31405-5929 | 2008-07-10 |
| 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.