SOUTHCOAST MEDICAL GROUP LLC NPI 1467451922

NPI Information

  • NPI: 1467451922
  • Provider Name: SOUTHCOAST MEDICAL GROUP, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 11D0264597
  • Address: 330 BENEFIELD DR
    SAVANNAH, GA
    ZIP 31406
  • Phone: (912) 303-3552

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NPI Details

SOUTHCOAST MEDICAL GROUP, LLC is a family medicine in Savannah, GA. The provider is 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. SOUTHCOAST MEDICAL GROUP, LLC NPI is 1467451922. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

330 BENEFIELD DR
SAVANNAH, GA
ZIP 31406-604
Phone: (912) 303-3552
Fax: (912) 303-3506

The provider's authorized official is John Marrero .
The authorized official title is Administrator and has the following contact phone number (912) 303-3552.

The CLIA number assigned to this NPI record is 11D0264597 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/18/2005 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0400XPsychiatry & NeurologyNeurology064752GEORGIANo
2207RN0300XInternal MedicineNephrology047425GEORGIANo
3207V00000XObstetrics & Gynecology022482GEORGIANo
4208600000XSurgery021614GEORGIANo
5207R00000XInternal MedicineGEORGIANo
6207RC0000XInternal MedicineCardiovascular DiseaseGEORGIANo
7207RI0200XInternal MedicineInfectious DiseaseGEORGIANo
8207RP1001XInternal MedicinePulmonary DiseaseGEORGIANo
9207W00000XOphthalmologyGEORGIANo
10208000000XPediatricsGEORGIANo
112085R0202XRadiologyDiagnostic RadiologyGEORGIANo
12225100000XPhysical TherapistGEORGIANo
13363A00000XPhysician AssistantGEORGIANo
14363L00000XNurse PractitionerGEORGIANo
15207Q00000XFamily MedicineGEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1909802000MEDICAIDFLORIDA
2GPA3131MEDICAIDSOUTH CAROLINA
3GPA643MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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