Individual provider Active NPI

John Magruder Read III, M. D.

  • Internal Medicine Physician
  • Tucker, GA
National Provider Identifier
1154435279
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17722 Issued in GA
Practice address
2362 Main St
Tucker, GA 30084-4477
Phone
(770) 938-1266
Fax
(770) 939-4093
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17722 GA Primary
General Practice Physician 208D00000X 17722 GA

Addresses

Primary practice location

2362 Main St
Tucker, GA 30084-4477

Mailing address

PO Box 769609
Roswell, GA 30076-8224
Phone (770) 938-1266

Other identifiers 2

IdentifierTypeStateIssuer
000088525JMedicaidGA
1609816123OtherGAGROUP NPI GEORGIA CLINIC PC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17722GAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1154435279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 769609",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300768224",
            "telephone_number": "770-938-1266",
            "fax_number": "770-939-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2362 MAIN ST",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844477",
            "telephone_number": "770-938-1266",
            "fax_number": "770-939-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "READ",
        "first_name": "JOHN",
        "middle_name": "MAGRUDER",
        "name_suffix": "III",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "17722",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "17722",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000088525J",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI GEORGIA CLINIC PC",
            "identifier": "1609816123",
            "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 May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.