Individual provider Active NPI

George Cleland, MD

  • Internal Medicine Physician
  • Athens, GA
National Provider Identifier
1063503209
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
037175 Issued in GA
Practice address
740 Prince Avenue
Building 13
Athens, GA 30606-5906
Phone
(706) 549-8682
Fax
(706) 549-8684
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 037175 GA Primary

Addresses

Primary practice location

740 Prince Avenue
Building 13
Athens, GA 30606-5906

Mailing address

PO Box 1468
Athens, GA 30603-1468
Phone (706) 549-8682

Other identifiers 1

IdentifierTypeStateIssuer
00612697IMedicaidGA

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
I20060111000007 GA Practitioner - Internal Medicine 6204859770 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Elbert County Internal Medicine, L.L.C. Internal Medicine CurrentSince Mar 14, 2016 Accepting new patients
Bradford Family Physicians LLC PastSince Oct 1, 2016 Accepting new patients
Ashok Patel,MD PA Internal Medicine PastSince Oct 1, 2000 Accepting new patients

Locations

740 Prince Ave
Ste 13
Athens, GA 30606
Phone (706) 433-0890

Organizations & group practices 4

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1063503209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1468",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306031468",
            "telephone_number": "706-549-8682",
            "fax_number": "706-549-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 PRINCE AVENUE",
            "address_2": "BUILDING 13",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065906",
            "telephone_number": "706-549-8682",
            "fax_number": "706-549-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLELAND",
        "first_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "037175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00612697I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.