Active NPI
Ronald A Homer, MD
- Pediatrics Physician
- Tucker, GA
National Provider Identifier
1124072822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 050105
- Practice address
- 1370 Montreal Rd
Ste 180
Tucker, GA 30084 - Phone
- (404) 446-4600
- Fax
- (404) 446-4601
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 050105 | GA | Primary |
Addresses
Primary practice location
1370 Montreal Rd
Ste 180
Tucker, GA 30084
Mailing address
1370 Montreal Rd
Ste 180
Tucker, GA 30084
Phone (404) 446-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000940266K | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050105 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dekalb Pediatric Associates PC | Pediatrics | Past | Accepting new patients |
| University Physicians Group P C | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FCBBAA/Endpoint/FCBBAA
- https://fhir4.healow.com/fhir/r4/FCBBAA
- ronald.homer@dpapeds.eclinicaldirectplus.com
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Tucker, GA
- NPI 1376829911
-
- General Practice Physician
- Staten Island, NY
- NPI 1104872134
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302739200000",
"number": "1124072822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1370 MONTREAL RD",
"address_2": "STE 180",
"city": "TUCKER",
"state": "GA",
"postal_code": "30084",
"telephone_number": "404-446-4600",
"fax_number": "404-446-4601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1370 MONTREAL RD",
"address_2": "STE 180",
"city": "TUCKER",
"state": "GA",
"postal_code": "30084",
"telephone_number": "404-446-4600",
"fax_number": "404-446-4601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOMER",
"first_name": "RONALD",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2011-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "050105",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000940266K",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.