Individual provider Active NPI

Michael S. Vavrik, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Carrollton, GA
National Provider Identifier
1003915158
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
047859 Issued in GA
Practice address
905 Dixie St
Carrollton, GA 30117-4408
Phone
(678) 796-0681
Fax
(770) 836-8477
NPI assigned
Sep 22, 2006
Last updated
Mar 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 047859 GA Primary

Addresses

Primary practice location

905 Dixie St
Carrollton, GA 30117-4408

Mailing address

905 Dixie St
Carrollton, GA 30117-4408
Phone (678) 796-0681

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
I20040416000738 GA Practitioner - Endocrinology 1850386392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Loyola University of Chicago, Stritch School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

200 Allen Memorial Dr
Bremen, GA 30110-2012
Phone (770) 812-9666

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Medical Group Inc CurrentSince Dec 1, 2022 Accepting new patients
Mary M Feldman MD LLC CurrentSince Mar 20, 2017 Accepting new patients
Diabetes and Endocrinology Associates East Endocrinology, Diabetes & Metabolism Past Accepting new patients

Locations

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

410 Dixie St
Carrollton, GA 30117
Phone (678) 796-0681

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

Organizations & group practices 4

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

Hospital & facility affiliations 5

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1003915158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174408",
            "telephone_number": "678-796-0681",
            "fax_number": "770-836-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174408",
            "telephone_number": "678-796-0681",
            "fax_number": "770-836-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVRIK",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "047859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.