Organization Active NPI

Ear,Nose,& Throat of Northwest Georgia

  • Otolaryngology Physician
  • Rome, GA
National Provider Identifier
1114986163
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
12408 Issued in GA
Legal business name
EAR,NOSE,& THROAT OF NORTHWEST GEORGIA
Practice address
107 John Maddox Dr NW
Rome, GA 30165-1419
Phone
(706) 235-7008
NPI assigned
Mar 20, 2006
Last updated
Jan 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Authorized official

Name
Dr. Raymond Howard, M.D.NPI 1427041631
Title
President
Phone
(706) 235-0116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 12408 GA Primary

Addresses

Primary practice location

107 John Maddox Dr NW
Rome, GA 30165-1419

Mailing address

107 John Maddox Dr NW
Rome, GA 30165-1419
Phone (706) 235-5533

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040428000154 GA Part B Supplier - Clinic/Group Practice 3476540857 Receives reassigned benefits from 5 practitioners
Practice locations: Rome, GA

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
11D1009372Ear Nose and Throat of North West Georgia107 John Maddox Drive, Rome, GA 30165Certificate of waiverFeb 12, 2027

National Provider Directory

National Provider Directory

Locations

107 John Maddox Dr NW
Rome, GA 30165
Phone (706) 235-0116

Practitioners & affiliated clinicians

Practitioners 6

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": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1114986163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 JOHN MADDOX DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651419",
            "telephone_number": "706-235-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 JOHN MADDOX DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651419",
            "telephone_number": "706-235-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR,NOSE,& THROAT OF NORTHWEST GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-235-0116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "12408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.