WILLIAM JAMES BROMBERG (NPI# 1932131190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932131190 |
| Entity Type | Individual |
| Full Name | WILLIAM JAMES BROMBERG |
| Credential | MD |
| Practice Address |
4750 Waters Ave Suite 202 Savannah GA 31404-6200 |
| Practice Telephone | 9123507412 |
| Practice Fax Number | 9123507297 |
| Mailing Telephone | 9123507412 |
| Mailing Fax Number | 9123507297 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 051626 | GA | Allopathic & Osteopathic Physicians |
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
051626 | GA | Allopathic & Osteopathic Physicians |
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
051626 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000968261A | 05 | |
| GA | WELLCARE | 349724 | 01 |
| SC | G51626 | 05 | |
| GA | RR MEDICARE | 020052888 | 01 |
| GA | AMERIGROUP | 10063478 | 01 |
| Street Address |
4750 WATERS AVE SUITE 202 |
| 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 | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205192424 | Nathan John Klingensmith | Surgery | 69 Jesse Hill Jr Drive, Se, Glenn Memorial Building, 3rd Floor, Atlanta, GA 30303 | 2012-04-03 |
| 1306928809 | Kevin J Farrell | Surgery | 101 West Ponce Deleon Ave, Emory Medical Care Foundation Ste 331, Decatur, GA 30030 | 2006-10-20 |
| 1972503837 | Gregory R Strauther | Surgery | 200 S Enota Dr Ne, Suite 150, Gainesville, GA 30501-3473 | 2005-07-21 |
| 1841583119 | Brian H Gibson | Surgery | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2011-05-19 |
| 1699065573 | Wellstar Medical Group, LLC | Surgery | 55 Whitcher St Ne, Suite 130, Marietta, GA 30060-1156 | 2011-04-13 |
| 1710283460 | Malcolm Ingram Goodchild | Surgery | 2737 Warm Springs Rd, Building A, Columbus, GA 31904-6859 | 2011-01-28 |
| 1215248604 | James G Boron | Surgery | 55 Whitcher St Ne Ste 130, Marietta, GA 30060 | 2010-06-30 |
| 1427377043 | James Clifton Haynes | Surgery | 2500 Hospital Blvd Ste 290, Roswell, GA 30076-4918 | 2010-05-21 |
| 1700047784 | Keren Aviva Bashan-gilzenrat | Surgery | 55 Whitcher St Ne Ste 130, Marietta, GA 30060 | 2008-06-22 |
| 1790946762 | Katherine Kohler | Surgery | 69 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3033 | 2008-06-22 |
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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.