Individual provider Active NPI

Bobb G Cucher, MD

  • Internal Medicine Physician
  • Atlanta,, GA
National Provider Identifier
1003803347
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
018479 Issued in GA
Practice address
5669 Peachtree Dunwoody Rd. NE
Suite 390
Atlanta,, GA 30342-1736
Phone
(678) 843-6400
Fax
(678) 843-6405
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 018479 GA Primary

Addresses

Primary practice location

5669 Peachtree Dunwoody Rd. NE
Suite 390
Atlanta,, GA 30342-1736

Mailing address

1838 American Way
Lawrenceville, GA 30043-6611
Phone (770) 995-7622

Other identifiers 4

IdentifierTypeStateIssuer
055003709DMedicaidGA
055003709EMedicaidGA
055003709CMedicaidGA
018479OtherGALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090817000333 GA Practitioner - Internal Medicine 3678627254 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
018479GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC Internal Medicine CurrentSince Jan 1, 2012 Accepting new patients
Bobb G Cucher MD and Caroline M Abruzese MD LLC Internal Medicine Past Accepting new patients
The Medical Group of Saint Joseph'S, LLC Past Accepting new patients

Locations

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1003803347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1838 AMERICAN WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436611",
            "telephone_number": "770-995-7622",
            "fax_number": "770-995-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5669 PEACHTREE DUNWOODY RD. NE",
            "address_2": "SUITE 390",
            "city": "ATLANTA,",
            "state": "GA",
            "postal_code": "303421736",
            "telephone_number": "678-843-6400",
            "fax_number": "678-843-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCHER",
        "first_name": "BOBB",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "018479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055003709D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055003709E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055003709C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "018479",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta,, GA

Sources for this page

Verify at the official NPI Registry.