SOUTHCOAST MEDICAL GROUP, LLC (NPI# 1881947802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881947802 |
| Entity Type | Organization |
| Organization Name | SOUTHCOAST MEDICAL GROUP, LLC |
| Practice Address |
3780 Us Highway 17 Richmond Hill GA 31324-3378 |
| Mailing Address |
Po Box 15849 Savannah GA 31416-2549 |
| Practice Telephone | 9127562292 |
| Practice Fax Number | 9127562289 |
| Mailing Telephone | 9123033552 |
| Mailing Fax Number | 9123033506 |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2012-10-16 |
| Authorized Official Name | JOHN MARRERO (ADMINISTRATOR) |
| Authorized Official Telephone | 9123033552 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 039759 | GA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 042084 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467451922 | Southcoast Medical Group, LLC | Psychiatry & Neurology | 330 Benefield Dr, Savannah, GA 31406-2604 | 2005-07-18 |
| 1861745119 | Southcoast Medical Group, LLC | Family Medicine | 1326 Eisenhower Dr, Savannah, GA 31406-3928 | 2012-10-24 |
| Street Address |
3780 US HIGHWAY 17 |
| City | RICHMOND HILL |
| State | GA |
| Zip Code | 31324-3378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386688554 | Donald Keith Cobb | Internal Medicine | 3780 Us Highway 17, Richmond Hill, GA 31324-3378 | 2006-06-16 |
| 1922498377 | Chatham Orthopaedic Associates, Pa | Orthopaedic Surgery | 3780 Us Highway 17, Richmond Hill, GA 31324-3378 | 2015-01-23 |
| 1376952259 | Codi Jones | Nurse Practitioner | 3780 Us Highway 17, Richmond Hill, GA 31324 | 2014-08-05 |
| 1801185442 | Thomas Christopher Garner | Internal Medicine | 3780 Us Highway 17, Richmond Hill, GA 31324-3378 | 2011-04-05 |
| 1245544519 | Mppg, Inc. | Obstetrics & Gynecology | 3780 Us Highway 17, Richmond Hill, GA 31324-3378 | 2010-07-29 |
| 1861683526 | Billy Darren Preuninger | Obstetrics & Gynecology | 3780 Us Highway 17, Richmond Hill, GA 31324 | 2007-08-07 |
| 1780752550 | Mppg, Inc. | Colon & Rectal Surgery | 3780 Us Highway 17, Richmond Hill, GA 31324-3378 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902389588 | Bryan Anderson | Physician Assistant | 8435 Vanguard Road, Fort Stewart, GA 31324 | 2018-09-10 |
| 1366941684 | Codie Wiley | Physician Assistant | Expercare Urgent Care 60 Exchange Street, Suite B7, Richmond Hill, GA 31324 | 2018-02-02 |
| 1174038145 | Shelly Stewart Childers | Nurse Practitioner | 2453 U.S. 17, Suite G, Richmond Hill, GA 31324 | 2017-12-12 |
| 1619495215 | Kristi Oxley | Nurse Practitioner | 2701 Us Hwy 17 Ste 1b, Richmond Hill, GA 31324 | 2017-09-03 |
| 1275062564 | Janice Tillman Gravitt | Registered Nurse | 60 Long Creek Lane, Richmond Hill, GA 31324 | 2017-06-08 |
| 1336680065 | Choice Care Medical | Durable Medical Equipment & Medical Supplies | 9390 Ford Ave Ste 9, Richmond Hill, GA 31324 | 2017-03-14 |
| 1750730263 | Haralabos Saltourides | Physical Therapy Assistant | 127 Carter Street, Richmond Hill, GA 31324 | 2016-06-06 |
| 1922462464 | Leia Edenfield | Student in an Organized Health Care Education/Training Program | 105 Balfour Dr, Richmond Hill, GA 31324 | 2016-04-11 |
| 1477931384 | Stephanie Eileen Banasik | Nurse Practitioner | 10200 Ford Ave. Ste. 101, Richmond Hill, GA 31324 | 2015-05-12 |
| 1962800771 | Kendra Seagraves | Nurse Practitioner | 9976 Ford Avenue, Richmond Hill, GA 31324 | 2014-12-10 |
| Find all providers in zip 31324 | ||||
| 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 |
|---|---|---|---|---|
| 1649744897 | J Rapha Healthcare Services Inc | Family Medicine | 100 Timber Trail Rd Ste 104, Richmond Hill, GA 31324-9416 | 2019-01-21 |
| 1801294699 | Richmond Hill Family Practice and Urgent Care LLC | Family Medicine | 10200 Ford Ave Ste 101, Richmond Hill, GA 31324-8824 | 2014-12-11 |
| 1629484902 | Frederick Harold | Family Medicine | 10055 Ford Avenue, Suite 3a, Richmond Hill, GA 31324 | 2014-07-07 |
| 1336375229 | Mushahid A Farooqi | Family Medicine | 121-08 Hillside Avenue, Richmond Hill, NY 11418 | 2009-06-05 |
| 1912179458 | Tahira F. Ghaffar | Family Medicine | 118-08 101 Ave, Richmond Hill, NY 11419 | 2008-03-25 |
| 1235325648 | Muzaffar Zai | Family Medicine | 12415 Jamaica Ave, Richmond Hill, NY 11418-2649 | 2007-09-19 |
| 1821115585 | Paul Chi-cheng Liang | Family Medicine | 2451a Highway 17, Richmond Hill, GA 31324 | 2007-03-26 |
| 1891861548 | Mppg, Inc. | Family Medicine | 3776 Us Highway 17, Richmond Hill, GA 31324-3378 | 2006-11-27 |
| 1003992033 | Philip Roopchand Baldeo | Family Medicine | 125-07 Liberty Avenue, Richmond Hill, NY 11419 | 2006-10-31 |
| 1689619975 | David Dovnarsky | Family Medicine | 13303 Jamaica Ave, Richmond Hill, NY 11418-2618 | 2006-06-19 |
| Find all providers in RICHMOND HILL | ||||
| City | RICHMOND HILL |
| Zip Code | 31324 |
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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.