Individual provider Active NPI

David Scott Whitcomb, MD

  • Neurology Physician
  • Marietta, GA
National Provider Identifier
1053303404
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
18767 Issued in GA
Practice address
1521 Johnson Ferry Rd
Suite 135
Marietta, GA 30062-6404
Phone
(770) 579-0777
Fax
(770) 579-3777
NPI assigned
Aug 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 18767 GA Primary

Addresses

Primary practice location

1521 Johnson Ferry Rd
Suite 135
Marietta, GA 30062-6404

Mailing address

1521 Johnson Ferry Rd
Suite 135
Marietta, GA 30062-6404
Phone (770) 579-0777

Other identifiers 1

IdentifierTypeStateIssuer
000132404HMedicaidGA

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
I20101104000135 GA Practitioner - Neurology 0345434262 Practice locations: Marietta, GA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018767GAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Josephs Hospital of Atlanta Inc 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1053303404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 JOHNSON FERRY RD",
            "address_2": "SUITE 135",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626404",
            "telephone_number": "770-579-0777",
            "fax_number": "770-579-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 JOHNSON FERRY RD",
            "address_2": "SUITE 135",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626404",
            "telephone_number": "770-579-0777",
            "fax_number": "770-579-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITCOMB",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-20",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "18767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000132404H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.