Ronald Clinton Atwater Jr., M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

72406 Issued in GA

Practice address

1178 5TH St SE
Cairo, GA 39828-3141

Phone

(229) 377-2002

NPI assigned

Jul 14, 2009

Last updated

Sep 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, TN2 enrollments

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 2

Specialty

General Surgery

Education

Meharry Medical College School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarksville Physician Services, LLCGroup PAC ID 0547276917, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suncrest Home Health Home health agency, Clarksville, TN, CCN 447298
• Vanderbilt Clarksville Hospital Hospital, Clarksville, TN, CCN 440035

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4
• Direct secure messaging: ronald.atwater.1@1879.direct.athenahealth.com
• Direct secure messaging: ronald.atwater@cairomedicalcare.gadirect.net
• Direct secure messaging: ronald.atwater@cmcl.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clarksville Physician Services LLC

  dba Vanderbilt Physician Services Clarksville

  • General Practice Physician
  • Clarksville, TN
  • NPI 1083657829

  Surgery

  Medicare reassignment Care Compare group NPD
• Cairo Medical Care, LLC

  • Family Medicine Physician
  • Cairo, GA
  • NPI 1861572067
  Medicare reassignment NPD
• Tift Regional Health System Inc

  dba Tift Regional Ophthalmology

  • Ophthalmology Physician
  • Tifton, GA
  • NPI 1790280857
  NPD
• Tift Regional Health System Inc

  dba South GA Surgical

  • Surgery Physician
  • Tifton, GA
  • NPI 1912315094
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)
• Clarksville Physician Services, LLC

  dba Dover Medical Clinic

  • Rural Health Clinic/Center
  • Dover, TN
  • NPI 1992077077
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clarksville Health System, LLC

  dba Tennova Healthcare-Clarksville

  • General Acute Care Hospital
  • Clarksville, TN
  • NPI 1285689794
  Care Compare affiliation
• Clarksville Home Care Services LLC

  dba SunCrest Home Health

  • Home Health Agency
  • Clarksville, TN
  • NPI 1427003607
  Care Compare affiliation

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1104056951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 5TH ST SE",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398283141",
            "telephone_number": "229-377-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 5TH ST SE",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398283141",
            "telephone_number": "229-377-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWATER",
        "first_name": "RONALD",
        "middle_name": "CLINTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "72406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003148404A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ronald.atwater.1@1879.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1178 5th St SE",
            "city": "Cairo",
            "state": "GA",
            "country_code": "US",
            "postal_code": "398283141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina Ellen Alicea
• Hope Almon, PTA
• Cherelle L Anderson, ST
• Angels of Grace Community Wellness Center, Inc.
• Archbold Medical Group (Cairo Internal Medicine)
• Axis Chiropractic LLC
• Danielle Bach, LD
• Megan Baggett, PHARMD
• Abdul Bari, M.D.
• Megan Beall

• Surgery Physician in Cairo, GA
• Providers in Cairo, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.

Verify at the official NPI Registry.