Organization Active NPI

Good Shepherd Clinic of Dawson County, Inc.

  • Community Health Clinic/Center
  • Dawsonville, GA
National Provider Identifier
1083491799
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
GOOD SHEPHERD CLINIC OF DAWSON COUNTY, INC.
Practice address
45 Medical Center Dr
Dawsonville, GA 30534-6297
Phone
(706) 429-9914
Fax
(706) 429-9921
NPI assigned
Sep 14, 2023
Last updated
Sep 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Authorized official

Name
Dr. David K Moore, MD
Title
Medical Director
Phone
(404) 805-4834

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU Primary

Addresses

Primary practice location

45 Medical Center Dr
Dawsonville, GA 30534-6297

Mailing address

452 Highway 53 E Unit 1009
Dawsonville, GA 30534-4153
Phone (706) 429-9914

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2163156Good Shepherd Clinic of Dawson Co, Inc45 Medical Center Drive, Dawsonville, GA 30534Certificate of waiverMar 7, 2027

National Provider Directory

National Provider Directory

Locations

452 Highway 53 E
Unit 1009
Dawsonville, GA 30534

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1083491799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 HIGHWAY 53 E UNIT 1009",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305344153",
            "telephone_number": "706-429-9914",
            "fax_number": "706-429-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MEDICAL CENTER DR",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346297",
            "telephone_number": "706-429-9914",
            "fax_number": "706-429-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD CLINIC OF DAWSON COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "404-805-4834",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.