Joseph William Ivory, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DNF000430 Issued in GA

Practice address

1120 15TH St
Augusta, GA 30912

Phone

(706) 721-8623

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, GA2 enrollments

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 2

Specialty

Maxillofacial Surgery

Education

University of Iowa College of Dentistry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Surgical Arts LLCGroup PAC ID 5193132975, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vision Surgical Arts, LLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Saint Louis, MO
  • NPI 1366039075
  Medicare reassignment Care Compare group NPD
• Au Medical Associates Inc

  • Multi-Specialty Clinic/Center
  • Augusta, GA
  • NPI 1841230620
  Medicare reassignment NPD
• Au Medical Associates Inc

  • Durable Medical Equipment & Medical Supplies
  • Augusta, GA
  • NPI 1114574126
  NPD
• Oral Facial Surgery Institute of Illinois P C

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Belleville, IL
  • NPI 1740697333
  NPD
• Clarkson Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Chesterfield, MO
  • NPI 1114498946
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1184603136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST STE BI1056",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30912",
            "telephone_number": "706-721-8623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "BLDG 38801 ACADEMIC DR",
            "address_2": "SUITE B & C",
            "address_purpose": "LOCATION",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "country_code": "US",
            "telephone_number": "706-787-2601",
            "fax_number": "915-742-4885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "BLDG 38801 ACADEMIC DR",
            "address_2": "SUITE B & C",
            "address_purpose": "LOCATION",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "country_code": "US",
            "telephone_number": "706-787-2601",
            "fax_number": "915-742-4885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVORY",
        "first_name": "JOSEPH",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS08292",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": "DDS08292",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DNF000430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda D Iverson, LCSW
• Ashley M Ivey, CPS-AD, FPM
• Janine Ivey
• Porche Ivey
• Tavories Ivey Sr., HAIR LOSS SPECIALIST
• Ivy Collaborative Healthcare LLC
• Vanessa Iweanya
• Shyam S Iyer, M.D.
• J. Michael Scott, DMD, P.C.
• J. Valencia Style Studio

• Oral and Maxillofacial Surgery (Dentist) in Augusta, GA
• Providers in Augusta, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.