Individual provider Active NPI

Dent W. Purcell, M.D.

  • Specialist
  • Rincon, GA
National Provider Identifier
1023019338
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
GA 12545 Issued in GA
Practice address
410 Willowpeg Way
Rincon, GA 31326-9157
Phone
(912) 826-5465
Fax
(912) 826-4851
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X GA 12545 GA Primary

Addresses

Primary practice location

410 Willowpeg Way
Rincon, GA 31326-9157

Mailing address

2864 Johnson Ferry Rd
Suite 150
Marietta, GA 30062-5635
Phone (770) 693-2622

Other identifiers 1

IdentifierTypeStateIssuer
00060607AMedicaidGA

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
GA 12545GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Statesboro Oncology Assoc. Specialist Past Accepting new patients
Radiation Therapy Associates Specialist Past Accepting new patients
Northeast Regional Radiation Oncology Network Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dent.purcell@westgahealth.gadirect.net

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1023019338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2864 JOHNSON FERRY RD",
            "address_2": "SUITE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625635",
            "telephone_number": "770-693-2622",
            "fax_number": "770-693-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 WILLOWPEG WAY",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313269157",
            "telephone_number": "912-826-5465",
            "fax_number": "912-826-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "DENT",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "GA 12545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00060607A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.