GEORGIA OUTREACH, LLC – Psychiatry Physician, NPI 1902128929
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for GEORGIA OUTREACH, LLC
408 E Bolton St Ste C
Savannah, GA 314015920
Phone: (912) 541-2397
Type: Location
131 Canal St Ste D
Pooler, GA 313226018
Phone: (912) 988-3181
Type: Location
135 Goshen Road Ext Ste 203
Rincon, GA 313265569
Phone: (912) 355-3881
Fax: (912) 335-3490
Type: Location
Hodgson Memorial Drive, Chippewa Terrace, Savannah, Chatham County, Georgia, 31406-4805, United States
SAVANNAH, GA 314061527
Phone: (912) 355-3881
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-04-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-06-30 (349 days ago).
Enrollment records
1
Earliest due date
2025-06-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20110425000693 | O | Clinic/Group Practice | GA | 2025-06-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31401)
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