MPPG, INC. (NPI# 1770644841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770644841 |
| Entity Type | Organization |
| Organization Name | MPPG, INC. |
| Other Organization Name | CARDIOVASCULAR & THORACIC SURGERY ASSOCIATION |
| Practice Address |
4750 Waters Ave Suite 452 Savannah GA 31404-6200 |
| Mailing Address |
Po Box 102032 Atlanta GA 30368-2032 |
| Practice Telephone | 9123547188 |
| Practice Fax Number | 9123545208 |
| Mailing Telephone | 9123547188 |
| Mailing Fax Number | 9123545208 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2011-05-31 |
| Authorized Official Name | ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR) |
| Authorized Official Telephone | 9123509335 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 300031676A | 05 | |
| SC | GPA594 | 05 | |
| GA | RAILROAD MEDICARE GROUP | CH5121 | 01 |
| Other Name | Type Code |
|---|---|
| Cardiovascular & Thoracic Surgery Association | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669602280 | Mppg, Inc. | Obstetrics & Gynecology | 1004 Memorial Ln, Suite 500, Savannah, GA 31410-1254 | 2009-07-16 |
| 1710041587 | Mppg, Inc. | Pediatrics | 512b South Main Street, Hinesville, GA 31313 | 2006-12-19 |
| 1871653469 | Mppg, Inc. | Internal Medicine | 4451 Paulsen Street, Savannah, GA 31405 | 2006-12-12 |
| 1588723266 | Mppg, Inc. | Family Medicine | 1001 Memorial Lane, Savannah, GA 31410 | 2006-12-08 |
| 1811057250 | Mppg, Inc. | Family Medicine | 1107 East 66th Street, Savannah, GA 31404 | 2006-12-08 |
| 1467511949 | Mppg, Inc. | Family Medicine | 14089 Abercorn Street, Savannah, GA 31419 | 2006-12-08 |
| 1790844389 | Mppg, Inc. | Internal Medicine | 455 South Maine Street, Suite 203, Hinesville, GA 31313 | 2006-12-08 |
| 1508925454 | Mppg, Inc. | Family Medicine | 105 Rocky Ford Road, Sylvania, GA 30467 | 2006-12-06 |
| 1174691067 | Mppg, Inc. | Radiology | 200 Maple Drive, Vidalia, GA 30474 | 2006-12-01 |
| 1891861548 | Mppg, Inc. | Family Medicine | 3776 Us Highway 17, Richmond Hill, GA 31324-3378 | 2006-11-27 |
| Street Address |
4750 WATERS AVE SUITE 452 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404-6200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538168109 | Jill Katrice Beckworth | Nurse Practitioner | 4750 Waters Ave, Suite 202, Savannah, GA 31404-6200 | 2005-07-18 |
| 1881177954 | Holly Nicole Klepek | Genetic Counselor, MS | 4750 Waters Ave, Savannah, GA 31404-6200 | 2018-09-13 |
| 1477001659 | Sabrina Renee Williams | Genetic Counselor, MS | 4750 Waters Ave, Suite 302, Savannah, GA 31404-6200 | 2016-09-15 |
| 1871978148 | Blanche L. Etheridge | Nurse Practitioner | 4750 Waters Ave, Suite 202, Savannah, GA 31404-6200 | 2015-07-28 |
| 1871974923 | Joshua Milby | Physician Assistant | 4750 Waters Ave, Ste 202, Savannah, GA 31404-6200 | 2015-06-15 |
| 1811385800 | April M Downing | Registered Nurse | 4750 Waters Ave, #206, Savannah, GA 31404-6200 | 2014-12-30 |
| 1538563408 | Rebecca Brewster | Physician Assistant | 4750 Waters Ave, Suite 202, Savannah, GA 31404-6200 | 2014-10-21 |
| 1629487855 | Patricia A Haselden | Nurse Practitioner | 4750 Waters Ave, Ste 500, Savannah, GA 31404 | 2014-08-13 |
| 1598194318 | Ashmed Vazquez Md PC | Obstetrics & Gynecology | 4750 Waters Ave, Suite 450, Savannah, GA 31404-6200 | 2013-11-02 |
| 1902145451 | Stephanie Alston | Health Educator | 4750 Waters Ave, Suite 452, Savannah, GA 31404-6200 | 2013-02-04 |
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| 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 | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134407075 | Robert A Hall Md LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Longfield Ct, Savannah, GA 31410-3513 | 2011-07-26 |
| 1124183926 | Cardiothoracic Surgery of Savannah PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11806 Mercy Blvd, Savannah, GA 31419 | 2006-12-22 |
| 1609801810 | Brian Marcus Bailey | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5354 Reynolds St Ste 102, Savannah, GA 31405-6008 | 2006-07-12 |
| 1558325845 | David V Capallo | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 900 Mohawk Street Ste E, Savannah, GA 31419 | 2006-04-13 |
| 1952391864 | Robert E. Jones | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 602 E 72nd St, Savannah, GA 31405-4913 | 2005-10-24 |
| 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 |
| 1073737656 | Chadwick William Stouffer | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4700 Waters Ave Ste 400, Savannah, GA 31404 | 2007-04-13 |
| 1598886277 | John A Shallal | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5354 Reynolds Street, Suite 206, Savannah, GA 31405-6009 | 2007-04-02 |
| 1932253762 | Mppg, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4700 Waters Ave, Suite 403, Savannah, GA 31404-6220 | 2007-01-22 |
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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.