Individual provider Active NPI

Jagadishwar Devkota, M.D.

  • General Practice Physician
  • Augusta, GA
National Provider Identifier
1013099001
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
017602 Issued in GA
Practice address
20 Winged Foot Dr
Augusta, GA 30907-9140
Phone
(706) 414-8235
Fax
(706) 364-2606
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 017602 GA
General Practice Physician 208D00000X 017602 GA Primary

Addresses

Primary practice location

20 Winged Foot Dr
Augusta, GA 30907-9140

Mailing address

20 Winged Foot Dr
Augusta, GA 30907-9140
Phone (706) 414-8235

Other identifiers 1

IdentifierTypeStateIssuer
00185138DMedicaidGA

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

LicenseStateTypeSpecialty
017602GAMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radcare of Tennessee PC Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1013099001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WINGED FOOT DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309079140",
            "telephone_number": "706-414-8235",
            "fax_number": "706-364-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WINGED FOOT DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309079140",
            "telephone_number": "706-414-8235",
            "fax_number": "706-364-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVKOTA",
        "first_name": "JAGADISHWAR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "GA",
            "license": "017602",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "017602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00185138D",
            "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 Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.