TATTNALL HOSPITAL COMPANY, LLC (NPI# 1639562978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639562978 |
| Entity Type | Organization |
| Organization Name | TATTNALL HOSPITAL COMPANY, LLC |
| Other Organization Name | OPTIM MEDICAL CENTER - TATTNALL |
| Practice Address |
1111 Glynco Pkwy Suite 30 - A Summit Professional Plaza I Brunswick GA 31525-7921 |
| Mailing Address |
210 E Derenne Ave Attn.: Provider Enrollment Savannah GA 31405-6736 |
| Practice Telephone | 9126445300 |
| Practice Fax Number | 9126445260 |
| Mailing Telephone | 9126445300 |
| Mailing Fax Number | 9126445260 |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-07-27 |
| Authorized Official Name | MR. ROBERT GUENTHNER (SECRETARY OF COMM.HOSP.HOLD.CO., LL) |
| Authorized Official Telephone | 3126278427 |
| Is Organization Subpart | Y |
| Parent Organization Name | TATTNALL HOSPITAL COMPANY, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Optim Medical Center - Tattnall | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912566811 | Tattnall Hospital Company, LLC | Clinic/Center | 10200 Ford Ave Ste 105, Richmond Hill, GA 31324-8824 | 2019-06-13 |
| 1285132415 | Tattnall Hospital Company, LLC | Family Medicine | 380a Cedar St, Metter, GA 30439 | 2018-01-23 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1093115123 | Tattnall Hospital Company, LLC | Neurological Surgery | 3345 Us Highway 84, Suite 100, Blackshear, GA 31516-2159 | 2014-08-26 |
| 1790112571 | Tattnall Hospital Company, LLC | Surgery | 1702-a Meadows Lane, Vidalia, GA 30474 | 2013-10-10 |
| 1720322464 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 38 S. Tallahassee Street, Suite B, Hazlehurst, GA 31539 | 2012-11-19 |
| 1013261312 | Tattnall Hospital Company, LLC | Physical Medicine & Rehabilitation | 8. North Williams Street, Metter, GA 30439 | 2012-11-08 |
| 1245501063 | Tattnall Hospital Company, LLC | Physical Medicine & Rehabilitation | 5918 Ogeechee Rd, Savannah, GA 31419-9527 | 2012-01-25 |
| 1154614360 | Tattnall Hospital Company, LLC | Family Medicine | 1811 Edwina Drive, Vidalia, GA 30474 | 2011-05-20 |
| 1891009924 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 110 East Tollison Street, Baxley, GA 31513 | 2010-07-30 |
| Street Address |
1111 GLYNCO PKWY SUITE 30 - A SUMMIT PROFESSIONAL PLAZA I |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31525-7921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922089713 | Northwest Diagnostic Imaging, Inc | Radiology | 1111 Glynco Pkwy, Brunswick, GA 31525-7921 | 2005-11-08 |
| 1487047726 | Optim Orthopedics, LLC | Orthopaedic Surgery | 1111 Glynco Pkwy, Suite 30 - A Summit Professional Plaza I, Brunswick, GA 31525-7921 | 2015-03-11 |
| 1376960179 | Joseph Durant | Specialist | 1111 Glynco Pkwy, Ste. 400, Brunswick, GA 31525-7921 | 2014-03-19 |
| 1760815880 | Kendra Curry | Social Worker | 1111 Glynco Pkwy, Bldg 2, Suite 200, Brunswick, GA 31525-7921 | 2013-08-12 |
| 1144575168 | Karah Lynn Brown | Physician Assistant | 1111 Glynco Pkwy, #2-100, Brunswick, GA 31525-7921 | 2012-07-16 |
| 1659643955 | Costrini & Meadows PC | Internal Medicine | 1111 Glynco Pkwy, Suite 410, Brunswick, GA 31525-7921 | 2012-02-01 |
| 1285917401 | Micah Henderson Lancaster | Physician Assistant | 1111 Glynco Pkwy, Building 1, Suite 20, Brunswick, GA 31525-7921 | 2011-09-23 |
| 1114215498 | Florida Bracing Centers, Inc. | Prosthetic/Orthotic Supplier | 1111 Glynco Pkwy, Building 2, Suite 110, Brunswick, GA 31525-7921 | 2011-07-20 |
| 1801105275 | Dublin Vamc | Clinic/Center | 1111 Glynco Pkwy, Summit Professional Plaza, Suite 200, Brunswick, GA 31525-7921 | 2010-10-01 |
| 1538495999 | Neurological Institute of Atlanta | Psychiatry & Neurology | 1111 Glynco Pkwy, Ste 400, Brunswick, GA 31525-7921 | 2009-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063905990 | Jonathon Wesley Capps | Physician Assistant | 1111 Glynco Pkwy Bldg 1, Ste 10, Brunswick, GA 31525 | 2018-06-14 |
| 1366993628 | Hands Down Muscle Restoration, Inc | Homeopath | 1212 Chapel Crossing Road, Brunswick, GA 31525 | 2016-10-20 |
| 1619424173 | Jebediah S Christy Dds - Brunswick Pllc | Dentist | 11455 Canal Crossing, Brunswick, GA 31525 | 2016-09-01 |
| 1831545508 | Heller Family Medicine, LLC | General Practice | 208 Scranton Connector Ste 120, Brunswick, GA 31525 | 2016-05-11 |
| 1437525391 | Natisha Danielle Hill | Occupational Therapy Assistant | 138 Wingefield Commons Drive, Brunswick, GA 31525 | 2015-08-14 |
| 1811269632 | Solar Family Practice | Family Medicine | 122 Scranton Connector, Suite 112, Brunswick, GA 31525 | 2012-02-09 |
| 1700187895 | Chetan Patel | Pharmacist | 12 Woodfall Ct, Brunswick, GA 31525 | 2010-11-05 |
| 1194914275 | Dialysis of Golden Isles, LLC | Clinic/Center | 475 Gateway Center Blvd, Brunswick, GA 31525 | 2007-10-15 |
| 1902939325 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Frazier Street, Brunswick, GA 31525 | 2007-03-14 |
| 1609909498 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 115 Frazier Road, Brunswick, GA 31525 | 2007-03-13 |
| Find all providers in zip 31525 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841387115 | Gary Kaufman | Neurological Surgery | 1111 Glynco Pkwy, 3rd Floor, Brunswick, GA 31525-7921 | 2006-10-06 |
| 1649371907 | The Brain and Spine Center of Southeast Ga | Neurological Surgery | 1111 Glynco Pkwy, 3rd Floor, Brunswick, GA 31525-7921 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275505 | Apex Spine and Neurosurgery LLC | Neurological Surgery | 1295 Hembree Rd Ste 200 Bldg B, Roswell, GA 30076 | 2020-11-06 |
| 1457968372 | Reagan Medical Center | Neurological Surgery | 1295 Hembree Rd Ste 200, Roswell, GA 30076-5721 | 2020-09-24 |
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1831720408 | Jonathan Lau | Neurological Surgery | 1365 Clifton Rd Ne Ste B6168, Atlanta, GA 30322-1013 | 2020-01-31 |
| 1528612728 | The Neurological Institute of Savannah & Center for Spine, PC | Neurological Surgery | 101 St Josephs Candler Dr, Pooler, GA 31322-9579 | 2019-07-26 |
| 1770149478 | The Neurological Institute of Savannah & Center for Spine P C | Neurological Surgery | 2a Ed Moore Ct, Statesboro, GA 30458-5024 | 2019-05-17 |
| 1740758358 | Allspine Surgery Center-2 LLC | Neurological Surgery | 1944 Clairmont Rd, Decatur, GA 30033-3406 | 2018-11-13 |
| 1427531268 | Robert Burney II | Neurological Surgery | 101 Lakeview Dr, Hamilton, GA 31811-4365 | 2018-09-07 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1942727425 | The Neurological Institute of Savannah & Center for Spine P C | Neurological Surgery | 1805 Manning Dr, Vidalia, GA 30474-8921 | 2017-08-25 |
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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.