Active NPI
Philippe Gadegbeku, MD
- Emergency Medicine Physician
- Gainesville, GA
National Provider Identifier
1013980069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 033084
- Practice address
- 743 Spring St NE
Gainesville, GA 30501-3715 - Phone
- (770) 536-2146
- Fax
- (770) 536-7895
- NPI assigned
- Feb 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 033084 | GA | Primary |
Addresses
Primary practice location
743 Spring St NE
Gainesville, GA 30501-3715
Mailing address
PO Box 2938
Gainesville, GA 30503-2938
Phone (770) 536-2146
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93BFDX2 | Other | GA | MEDICARE PIN URGENT CARE FRIENDSHIP |
| 000429228K | Other | GA | MEDICAID URGENT CARE FRIENDSHIP |
| 000429228H | Medicaid | GA | |
| 000429228I | Medicaid | GA |
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 |
|---|---|---|---|
| 033084 | GA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherokee Emergency Services, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Atlanta, GA
- NPI 1992754717
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212537600000",
"number": "1013980069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2938",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305032938",
"telephone_number": "770-536-2146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "743 SPRING ST NE",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305013715",
"telephone_number": "770-536-2146",
"fax_number": "770-536-7895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GADEGBEKU",
"first_name": "PHILIPPE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2008-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "033084",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN URGENT CARE FRIENDSHIP",
"identifier": "93BFDX2",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID URGENT CARE FRIENDSHIP",
"identifier": "000429228K",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000429228H",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000429228I",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.