Individual provider Active NPI

Jules M Nehmetallah, MD

  • Hospitalist Physician
  • Waycross, GA
National Provider Identifier
1003880576
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
055262 Issued in GA
Practice address
410 Darling Ave
Waycross, GA 31501-5246
Phone
(913) 338-6438
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 055262 GA Primary
Internal Medicine Physician 207R00000X 055262 GA

Addresses

Primary practice location

410 Darling Ave
Waycross, GA 31501-5246

Mailing address

PO Box 173
Waycross, GA 31502-0173
Phone (912) 338-6438

Other identifiers 2

IdentifierTypeStateIssuer
735143213FMedicaidGA
P00239396OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041008000442 GA Practitioner - Internal Medicine 7214996073 Reassigns benefits to 3 organizations
I20200520001143 SC Practitioner - Internal Medicine 7214996073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Georgia PCGroup PAC ID 2961483607, 252 clinicians

Practice addresses (Care Compare)

302 University Pkwy
Aiken, SC 29801-6302
Phone (803) 641-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055262GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of South Carolina, LLC Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Hospitalist CurrentSince Jul 31, 2019 Accepting new patients
Mayo Clinic Health System in Waycross, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Mayo Clinic Health System in Waycross, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Integrated Regional Laboratories Pathology Services, LLC Current Accepting new patients
Acs Primary Care Physicians - Southeast PC CurrentSince Jul 31, 2019 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Apr 14, 2020 Accepting new patients
Aiken Regional Medical Centers LLC Past Accepting new patients

Locations

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

1921 Alice St
Ste 5A
Waycross, GA 31501
Phone (912) 283-4747

1921 Alice St
Ste 4A
Waycross, GA 31501
Phone (912) 283-5616

1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030

1921 Alice St
Ste 4B
Waycross, GA 31501
Phone (912) 285-5690

410 Darling Ave
Waycross, GA 31501
Phone (912) 283-3030

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Interoperability endpoints

  • Direct secure messaging: jules.nehmetallah@mhs.gadirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257206400000",
    "number": "1003880576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315020173",
            "telephone_number": "912-338-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 DARLING AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015246",
            "telephone_number": "913-338-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEHMETALLAH",
        "first_name": "JULES",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2009-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "055262",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "055262",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "735143213F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00239396",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.