Active NPI
John E Delzell Jr., M.D.
- Family Medicine Physician
- Gainesville, GA
National Provider Identifier
1073609756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 81030
- Practice address
- 1315 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3822 - Phone
- (770) 219-9445
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 04-31516 | KS | |
| Family Medicine Physician | 207Q00000X | ME117849 | FL | |
| Family Medicine Physician | 207Q00000X | 81030 | GA | Primary |
Addresses
Primary practice location
1315 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3822
Mailing address
PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420
Other practice location 1
11200 SW 8th St
Ahc2 #693
Miami, FL 33199-2516
Phone (305) 348-0705
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208258814 | Medicaid | MO | |
| 927874 | Other | KS | FIRSTGUARD |
| 100330800B | Medicaid | KS | |
| 21861028 | Other | MO | BCBS KANSAS CITY |
| P00278644 | Other | RAILROAD MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jdelzell34948@nghs.gadirect.net | Direct |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200518002539 | GA | Practitioner - Family Practice | 5092745174 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 87.83 of 100
- Quality
- 80.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.08
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-31516 | KS | MD | Family Medicine Physician |
| 35650 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Georgia Physicians Group Inc | Family Medicine | Current | Accepting new patients |
Locations
597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275
1315 Jesse Jewell Pkwy NE
Ste 300
Gainesville, GA 30501
Phone (770) 219-6520
Interoperability endpoints
- jdelzell34948@nghs.gadirect.net
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.
-
- Family Medicine Physician
- Gainesville, GA
- NPI 1891745212
Family Medicine, GA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613347200000",
"number": "1073609756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 742616",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303742616",
"telephone_number": "770-219-8420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 JESSE JEWELL PKWY NE STE 300",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305013822",
"telephone_number": "770-219-9445"
}
],
"practiceLocations": [
{
"address_1": "11200 SW 8th St",
"address_2": "AHC2 #693",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331992516",
"country_code": "US",
"telephone_number": "305-348-0705",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DELZELL",
"first_name": "JOHN",
"middle_name": "E",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2021-02-15",
"certification_date": "2021-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "04-31516",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME117849",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "81030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "208258814",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTGUARD",
"identifier": "927874",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100330800B",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS KANSAS CITY",
"identifier": "21861028",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00278644",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jdelzell34948@nghs.gadirect.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1315 Jesse Jewell Pkwy NE Ste 300",
"city": "Gainesville",
"state": "GA",
"country_code": "US",
"postal_code": "305013822",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.