Individual provider Active NPI

Erika L Dovie, P.A

  • Medical Physician Assistant
  • Gainesville, GA
National Provider Identifier
1104894609
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
004281 Issued in GA
Practice address
1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862
Phone
(770) 536-9864
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 004281 GA Primary

Addresses

Primary practice location

1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862

Mailing address

1320 Overland Park Dr
Braselton, GA 30517-1407
Phone (770) 965-7578

Other identifiers 3

IdentifierTypeStateIssuer
180899329EMedicaidGA
01614023OtherGAAMERIGROUP
004281OtherGAPA LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060228000735 GA Practitioner - Physician Assistant 8426064411 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Longstreet Clinic, PC CurrentSince Feb 27, 2012 Accepting new patients

Locations

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 297-2200

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1104894609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 OVERLAND PARK DR",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305171407",
            "telephone_number": "770-965-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-536-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVIE",
        "first_name": "ERIKA",
        "middle_name": "L",
        "credential": "P.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "004281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180899329E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01614023",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "004281",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.