J C LEWIS PRIMARY HEALTHCARE CENTER INC (NPI# 1750734372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750734372 |
| Entity Type | Organization |
| Organization Name | J C LEWIS PRIMARY HEALTHCARE CENTER INC |
| Practice Address |
3802 Waters Ave Savannah GA 31404-6210 |
| Mailing Address |
125 Fahm St Savannah GA 31401-2391 |
| Practice Telephone | 9123523845 |
| Practice Fax Number | 9123541980 |
| Mailing Telephone | 9124958887 |
| Mailing Fax Number | 9124958881 |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-19 |
| Authorized Official Name | LAURA ADAMS (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9127216705 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003125784C | 05 |
| Street Address |
3802 WATERS AVE |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404-6210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003184409 | Greer Gadsden Larned, M.d., P.C., Faap | Pediatrics | 3802 Waters Ave, Savannah, GA 31404-6210 | 2011-12-13 |
| 1891151403 | Shawntay Rogers | Lactation Consultant, Non-RN | 3802 Waters Ave, Savannah, GA 31404-6210 | 2016-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864580 | Carli A Boatright | Registered Nurse | 4750 Waters Ave Suite 206, Savannah, GA 31404 | 2019-08-01 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| 1336503291 | Miles Love | Student in an Organized Health Care Education/Training Program | 1250 East 66th Street, Savannah, GA 31404 | 2016-04-07 |
| 1134536881 | David Patch | Specialist/Technologist | Pediatric Residency Program, Memorial University, Medical Center 4700 Waters Avenue, Savannah, GA 31404 | 2014-07-15 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1730446394 | Joshua Ryan Fann | Prosthetist | 3840 Waters Ave, Savannah, GA 31404 | 2012-04-19 |
| Find all providers in zip 31404 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912505041 | Northwest Health Services Inc | Clinic/Center | 10500 State Route T, Savannah, MO 64485-2456 | 2020-10-12 |
| 1952941528 | Curtis V. Cooper Primary Health Care, Inc | Clinic/Center | 400 E Broad St, Savannah, GA 31401-5104 | 2020-01-13 |
| 1588188841 | J C Lewis Primary Health Care Center Inc | Clinic/Center | 1410 Richards St, Savannah, GA 31415-2038 | 2017-07-28 |
| 1588017412 | J C Lewis Primary Health Care Center Inc | Clinic/Center | 1110 May St, Savannah, GA 31415-5470 | 2016-07-15 |
| 1184077018 | J C Lewis Primary Health Care Center, Inc | Clinic/Center | 3100 Montgomery St, Savannah, GA 31405-3212 | 2016-07-15 |
| 1235492398 | Curtis V. Cooper Primary Health Care, Inc | Clinic/Center | 2121 E. Derenne Ave, Savannah, GA 31406 | 2012-06-22 |
| 1659668010 | Curtis V. Cooper Primary Health Care, Inc | Clinic/Center | 349 W Bryan St, Savannah, GA 31401-2356 | 2011-07-06 |
| 1003065772 | Hardin County Regional Health Center | Clinic/Center | 150 East End Drive, Savannah, TN 38372-1712 | 2008-09-17 |
| 1619167749 | Curtis V. Cooper Primary Health Care,inc | Clinic/Center | 840a Hitch Drive, Savannah, GA 31401-3040 | 2007-07-25 |
| 1316972599 | Curtis V. Cooper Primary Health Care, Inc | Clinic/Center | 2 Roberts Street, Savannah, GA 31408-3524 | 2006-07-12 |
| 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.