MPPG, INC.


Address: 4750 Waters Ave, Suite 307, Savannah, GA 31404-6200
Phone: 9123507914

MPPG, INC. (NPI# 1679640692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679640692
Entity Type Organization
Organization Name MPPG, INC.
Other Organization Name SAVANNAH PEDIATRIC SURGERY, INC.
Practice Address 4750 Waters Ave
Suite 307
Savannah
GA 31404-6200
Mailing Address Po Box 102032
Atlanta
GA 30368-2032
Practice Telephone 9123507914
Practice Fax Number 9123507973
Mailing Telephone 9123507914
Mailing Fax Number 9123507973
Enumeration Date 2006-11-29
Last Update Date 2011-06-01
Authorized Official Name ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
Authorized Official Telephone 9123509335
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0120X Surgery
Specialization: Pediatric Surgery
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Savannah Pediatric Surgery, Inc. Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 4750 WATERS AVE
SUITE 307
City SAVANNAH
State GA
Zip Code 31404-6200

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2086S0120X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Pediatric Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346393261 Miller Carlton Hamrick Surgery 4750 Waters Ave Ste 307, Savannah, GA 31404 2007-01-22
1174567309 William Carson Boswell Surgery 4750 Waters Ave Ste 307, Savannah, GA 31404-6268 2006-06-16
1962452250 David E Carney Surgery 4750 Waters Ave Ste 307, Savannah, GA 31404-6268 2006-05-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1184948739 Morgan Richards Surgery 1405 Clifton Rd Ne Dept Of, Atlanta, GA 30322 2010-03-24
1902083546 Andrew P Bozeman Surgery 100 Medical Dr Ste 100, Dublin, GA 31021-2561 2008-01-25
1720278856 Jonathan A Meisel Surgery 1400 Tullie Rd Ne Fl 1, Atlanta, GA 30329 2007-07-25
1326135591 Kurt Frederick Heiss Surgery 1975 Century Center, Suite #6, Atlanta, GA 30345 2006-10-06
1528151859 Amina Mira Bhatia Surgery 1975 Century Blvd Ne Ste 6, Atlanta, GA 30345-3316 2006-09-30
1760583710 Megan Marie Durham Surgery 1975 Century Blvd Ne, Suite 6, Atlanta, GA 30345-3316 2006-09-25
1467451039 Roger Mccoy Pitt Surgery 840 Pine St Ste 510, Macon, GA 31201-7530 2005-07-18
1790784221 Theodore Brand Surgery 5248 Timber Ridge Rd, M, Marietta, GA 30068 2005-07-18
1366441941 John Christopher Bleacher Surgery 5455 Meridian Marks Rd Ne, Suite 570, Atlanta, GA 30342-1654 2005-07-18
1558727289 Cardiothoracic Providers At Childrens Surgery 1575 Northeast Expy Ne, Brookhaven, GA 30329-2401 2016-01-11
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Competitor

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City SAVANNAH
Zip Code 31404

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Dataset Information

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.

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