Active NPI
Ravinder Jerath, M.D.
- Gynecology Physician
- Augusta, GA
National Provider Identifier
1013026830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 19957
- Practice address
- 2100 Central Ave
Suite 7
Augusta, GA 30904-6717 - Phone
- (706) 736-5378
- Fax
- (706) 738-9922
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 19957 | GA | Primary |
| Specialist | 174400000X | 19957 | GA |
Addresses
Primary practice location
2100 Central Ave
Suite 7
Augusta, GA 30904-6717
Mailing address
2100 Central Ave
Suite 7
Augusta, GA 30904-6717
Phone (706) 736-5378
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10048449 | Other | GA | AMERIGROUP |
| 342733 | Other | GA | WELLCARE MEDICAID |
| 00233901A | Medicaid | GA | |
| G19957 | Medicaid | SC | |
| 19957 | Other | GA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19957 | GA | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1013026830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 CENTRAL AVE",
"address_2": "SUITE 7",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309046717",
"telephone_number": "706-736-5378",
"fax_number": "706-738-9922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 CENTRAL AVE",
"address_2": "SUITE 7",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309046717",
"telephone_number": "706-736-5378",
"fax_number": "706-738-9922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JERATH",
"first_name": "RAVINDER",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "GA",
"license": "19957",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "GA",
"license": "19957",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10048449",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE MEDICAID",
"identifier": "342733",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00233901A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G19957",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "19957",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.