MPPG, INC. (NPI# 1477783959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477783959 |
| Entity Type | Organization |
| Organization Name | MPPG, INC. |
| Other Organization Name | PROVIDENT OB/GYN ASSOCIATES |
| Practice Address |
4750 Waters Ave Suite 311 Savannah GA 31404-6200 |
| Mailing Address |
Po Box 102032 Atlanta GA 30368-2032 |
| Practice Telephone | 9123505937 |
| Practice Fax Number | 9123507514 |
| Mailing Telephone | 9123505937 |
| Mailing Fax Number | 9123507514 |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2011-06-01 |
| Authorized Official Name | MRS. ROBIN J MADDOX (PROVIDER ENROLLMENT COORDINATOR) |
| Authorized Official Telephone | 9123509335 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Provident OB/GYN Associates | 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 311 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013257344 | Stephanie Denise Tootle | Obstetrics & Gynecology | 1004 Memorial Ln Ste 500, Savannah, GA 31410 | 2013-02-23 |
| 1033476692 | Jessica Miller Mullinix | Obstetrics & Gynecology | 5354 Reynolds St Ste 518, Savannah, GA 31405 | 2012-04-19 |
| 1194989426 | James D Smith Md PC | Obstetrics & Gynecology | 5354 Reynalds St, Suite 225, Savannah, GA 31405 | 2008-07-16 |
| 1427257484 | Lisa M Semple, Do PC | Obstetrics & Gynecology | 5353 Reynolds St Ste 201, Savannah, GA 31405-6087 | 2007-07-11 |
| 1730268046 | Michael Joseph Jackson | Obstetrics & Gynecology | 5311 Paulsen St, Savannah, GA 31405-4800 | 2006-11-06 |
| 1336225390 | James Anthony Carr | Obstetrics & Gynecology | 5204 Paulsen St, Savannah, GA 31405-4704 | 2006-10-31 |
| 1548358328 | Gregg Parker | Obstetrics & Gynecology | 910 E 70th St, Savannah, GA 31405-4815 | 2006-10-10 |
| 1972600021 | Ilan D Bornstein, M.d., L L C | Obstetrics & Gynecology | 4750 Waters Ave Ste 210, Savannah, GA 31404-6268 | 2006-09-20 |
| 1386740249 | Suresh I Persad-maharaj | Obstetrics & Gynecology | 361 B Commercial Dr., Savannah, GA 31406-3643 | 2006-09-16 |
| 1689779589 | Ashmed Vazquez | Obstetrics & Gynecology | 5354 Reynolds St Ste 304, Savannah, GA 31405-6010 | 2006-09-14 |
| 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.