Jairaj Goberdhan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

058179 Issued in GA

Practice address

407 N Parrish Ave
Adel, GA 31620-2076

Phone

(229) 896-1672

Fax

(229) 896-1676

NPI assigned

Jun 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Mercer University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southland Dodge Emergency Medical Services, LLC 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Tifton, GA, CCN 117077
• Dodge County Hospital Hospital, Eastman, GA, CCN 110092
• Southwell Medical, a Campus of TRMC Hospital, Adel, GA, CCN 110101

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Family Health Center of Adel, Inc.

  • Family Medicine Physician
  • Adel, GA
  • NPI 1124044292

  Family Medicine, GA

  Medicare reassignment NPD Authorized official
• Southland Dodge Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Eastman, GA
  • NPI 1851958607

  GA

  Medicare reassignment Care Compare group NPD
• Tift Regional Health System Inc

  • Ophthalmology Physician
  • Tifton, GA
  • NPI 1790280857
  NPD
• The Baxley and Appling County Hospital Authority

  • Rural Health Clinic/Center
  • Baxley, GA
  • NPI 1073752143
  NPD (past)

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

• Amedisys Georgia, L.L.C.

  • Home Health Agency
  • Tifton, GA
  • NPI 1356524359
  Care Compare affiliation
• Dodge County Hospital Authority

  • Rural Acute Care Hospital
  • Eastman, GA
  • NPI 1740272095

  Hospital

  Care Compare affiliation
• Tift Regional Health System, Inc.

  • General Acute Care Hospital
  • Adel, GA
  • NPI 1568410264

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1194760744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 N PARRISH AVE",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "316202076",
            "telephone_number": "229-896-1672",
            "fax_number": "229-896-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N PARRISH AVE",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "316202076",
            "telephone_number": "229-896-1672",
            "fax_number": "229-896-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBERDHAN",
        "first_name": "JAIRAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "058179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Empyrean Hospice of Georgia, LLC
• Family Health Center of Adel, Inc.
• Thomas D Fausett Jr., MD
• Shelby Lynn Fulghum
• Georgia Pines Community Service Board
• Ivy Lancaster Godwin, FNP
• Gold Standard Behavior Change Services
• Sara Knighton Gray, DMD
• Priscilla R Greene, FHNP
• Caryl Lynn Gulley, LMSW

• All providers in Adel, GA
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.