NPIMap

Organization Active NPI

Ronald D Patrick MD LLC

  • Surgery Physician
  • McDonough, GA
National Provider Identifier
1053649608
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036427 Issued in GA
Legal business name
RONALD D PATRICK MD LLC
Practice address
366 Racetrack Rd
McDonough, GA 30252-1022
Phone
(706) 331-5206
NPI assigned
Nov 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Authorized official

Name
Dr. Ronald D Patrick, M.D.
Title
President
Phone
(706) 331-5206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 036427 GA Primary

Addresses

Primary practice location

366 Racetrack Rd
McDonough, GA 30252-1022

Mailing address

366 Racetrack Rd
McDonough, GA 30252-1022
Phone (706) 331-5206

Other identifiers 3

IdentifierTypeStateIssuer
437742618AMedicaidGA
00525819CMedicaidGA
02BDGQZOtherGAMEDICARE PROVIDER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1053649608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 RACETRACK RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521022",
            "telephone_number": "706-331-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 RACETRACK RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521022",
            "telephone_number": "706-331-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD D PATRICK MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-19",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-331-5206",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "036427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "437742618A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00525819C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "02BDGQZ",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.