MEMORIAL MEDICAL ASSOCIATES - NPI 1740357649 - Internal Medicine in Savannah, GA

Q: What is the provider's specialty?

The provider's specialty is Internal Medicine with taxonomy code 207R00000X.

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About Memorial Medical Associates NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEMORIAL MEDICAL ASSOCIATES (NPI 1740357649) is a healthcare organization registered as an internal medicine in Savannah, Georgia and active in the NPI registry since November 2006. The organization lists Sebrena C. Holmes Gibson, Provider Enrollment Coordinator, as its authorized official.Information from the official NPPES registry record, last updated June 20, 2016.

NPPES Registry Identity

NPI1740357649

Entity TypeOrganization

Legal Business NameMPPG, INC.

Location Address6602 WATERS AVE, BLDG ASavannah, GA 31406-2758

Mailing AddressPo Box 102032Atlanta, GA 30368-2032 · (912) 350-6000 · Fax (912) 350-6001

Phone(912) 350-6000

Fax(912) 350-6001

Organization SubpartNo

Authorized OfficialSebrena C. Holmes GibsonProvider Enrollment Coordinator · (912) 350-9335

Enumeration DateNovember 29, 2006

Last NPPES UpdateJune 20, 2016

✔ NPI 1740357649 is a valid, active identifier and passes the ISO check-digit test. How NPI validation works

★ Primary Specialty

Internal Medicine

Taxonomy 207R00000X · Allopathic & Osteopathic Physicians

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly.… Show more

6602 WATERS AVE, Savannah, GA 31406

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Also on File with NPPES

Other Names1

Memorial Medical Associates (Doing Business As)

Group Practice1

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization. (193400000X SINGLE SPECIALTY GROUP)

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 11D0915493
Facility Type: Physician Office
Certificate Effective Date: January 28, 2024
Certificate Expiration Date: January 27, 2026
Laboratory Director: THOMAS J. HOGAN
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Memorial Medical Associates to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.