Provident Health Surgical Associates, Inc.
NPI 1104113307ActiveOrganization· Surgery· Savannah, GA
Surgery in Savannah, Georgia, registered in NPPES in July 2011. The authorized official on file is Robin J. Maddox, Provider Enrollment Coordinator.
Overview
| NPI | 1104113307 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 8, 2011 |
| Last updated in NPPES | Jul 8, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | — | — |
| Nurse Practitioner | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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