Individual provider Active NPI

Harold Adrian Minerve, M.D.

  • General Practice Physician
  • Dunwoody, GA
National Provider Identifier
1184837841
Registry record updated Sep 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
44544 Issued in GA
Practice address
4536 Chamblee Dunwoody Rd
Ste 250
Dunwoody, GA 30338-6200
Phone
(770) 455-6100
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 44544 GA
General Practice Physician 208D00000X 44544 GA Primary

Addresses

Primary practice location

4536 Chamblee Dunwoody Rd
Ste 250
Dunwoody, GA 30338-6200

Mailing address

4046 Preston Oaks PL
Lithonia, GA 30038-3986
Phone (770) 696-2071

Other practice location 1

7444 Hannover Pkwy S Ste 225
Stockbridge, GA 30281-7847
Phone (770) 679-0401

Other practice location 2

3579 Highway 138 SE Ste 103
Stockbridge, GA 30281-4127
Phone (770) 629-4374

Other identifiers 1

IdentifierTypeStateIssuer
000816582CMedicaidGA

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
I20050422000150 GA Practitioner - UrologyPractitioner - General Practice 0143268805 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
UrologyAlso: General Practice
Education
State University of New York Downstate Medical Center, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

833 N Hairston Rd
Stone Mountain, GA 30083-3423
Phone (770) 897-5553

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44544GAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stone Mountain Immediate Medical Care, Inc. Current Accepting new patients
Southern Crescent Medical Center, LLC CurrentSince Aug 28, 2019 Accepting new patients
Immune Recovery Foundation LLC Past Accepting new patients
Friendship Community Healthcare Inc Past Accepting new patients
Patriot Healthcare of Georgia, LLC Past Accepting new patients
Immune Recovery Institute Inc Past Accepting new patients

Locations

3579 Highway 138 SE
Ste 103
Stockbridge, GA 30281
Phone (770) 629-4374

833 N Hairston Rd
Stone Mtn, GA 30083
Phone (770) 879-5553

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569628800000",
    "number": "1184837841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4046 PRESTON OAKS PL",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300383986",
            "telephone_number": "770-696-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4536 CHAMBLEE DUNWOODY RD",
            "address_2": "STE 250",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303386200",
            "telephone_number": "770-455-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7444 Hannover Pkwy S Ste 225",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302817847",
            "country_code": "US",
            "telephone_number": "770-679-0401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3579 Highway 138 SE Ste 103",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302814127",
            "country_code": "US",
            "telephone_number": "770-629-4374",
            "fax_number": "678-782-6818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINERVE",
        "first_name": "HAROLD",
        "middle_name": "ADRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2019-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "44544",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "44544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000816582C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

Verify at the official NPI Registry.