NPIMap

Organization Active NPI

Evirtualcare, LLC

  • Internal Medicine Physician
  • Athens, GA
National Provider Identifier
1073050647
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
074767 Issued in GA
Legal business name
EVIRTUALCARE, LLC
Practice address
555 Forest Rd
Athens, GA 30605-3823
Phone
(706) 502-0503
NPI assigned
Jan 20, 2017
Last updated
Jul 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Authorized official

Name
Michael Myers
Title
Partner
Phone
(317) 794-8945

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 074767 GA Primary
Internal Medicine Physician 207R00000X 062964 GA
Internal Medicine Physician 207R00000X 076870 GA
Psychiatry Physician 2084P0800X 076870 GA

Addresses

Primary practice location

555 Forest Rd
Athens, GA 30605-3823

Mailing address

555 Forest Rd
Athens, GA 30605-3823

Other practice location 1

775 Sunset Dr
Athens, GA 30606-2211
Phone (999) 999-9999

Other practice location 2

709 Breedlove Dr
Monroe, GA 30655-2055
Phone (317) 794-8945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170308000573 GA Part B Supplier - Clinic/Group Practice 3375827579 Receives reassigned benefits from 33 practitioners
Practice locations: Athens, GA

National Provider Directory

National Provider Directory

Locations

367 Prince Ave
Ste H
Athens, GA 30601
Phone (706) 850-8870

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1073050647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 FOREST RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 FOREST RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053823",
            "telephone_number": "706-502-0503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 Sunset Dr",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062211",
            "country_code": "US",
            "telephone_number": "999-999-9999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "709 Breedlove Dr",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "GA",
            "postal_code": "306552055",
            "country_code": "US",
            "telephone_number": "317-794-8945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVIRTUALCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "317-794-8945"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "074767",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "062964",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "076870",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "076870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.