Individual provider Active NPI

Juan Antonio Ayerdi, MD

  • Student in an Organized Health Care Education/Training Program
  • Atlanta, GA
National Provider Identifier
1134069669
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1364 Clifton Rd NE
Atlanta, GA 30322-1002
Phone
(478) 733-5297
NPI assigned
Apr 1, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Atlanta, GA 30322-1002

Mailing address

2425 Averett Dr
Columbus, GA 31906-1569
Phone (478) 733-5297

Other practice location 1

550 Peachtree St NE
Atlanta, GA 30308-2212
Phone (478) 733-5297

Other practice location 2

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (478) 733-5297

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260514003571 GA Order and Referring Only - Vascular SurgeryPractitioner - Vascular Surgery 1254800659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1775001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1134069669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 AVERETT DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319061569",
            "telephone_number": "478-733-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221002",
            "telephone_number": "478-733-5297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Peachtree St NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303082212",
            "country_code": "US",
            "telephone_number": "478-733-5297",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Jesse Hill Jr Dr SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303033031",
            "country_code": "US",
            "telephone_number": "478-733-5297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AYERDI",
        "first_name": "JUAN",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-04-01",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.