NPIMap

Individual provider Active NPI

Douglas C. Redd, M.D.

  • Specialist
  • Atlanta, GA
National Provider Identifier
1205824497
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
5505 Peachtree Dunwoody Rd Ste 370
Atlanta, GA 30342-1713
Phone
(770) 538-1772
Fax
(770) 538-1773
NPI assigned
Oct 11, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary
Vascular & Interventional Radiology Physician 2085R0204X 32463 GA

Addresses

Primary practice location

5505 Peachtree Dunwoody Rd Ste 370
Atlanta, GA 30342-1713

Mailing address

5505 Peachtree Dunwoody Rd Ste 370
Atlanta, GA 30342-1713
Phone (770) 538-1772

Other practice location 1

4519 Woodruff Rd Ste 17
Columbus, GA 31904-6091
Phone (706) 221-8999

Other identifiers 5

IdentifierTypeStateIssuer
000755972LMedicaidGA
000755972QMedicaidGA
1460074OtherGACOVENTRY
1609510OtherGACIGNA
CA9328OtherGAMEDICARE-DMERC GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040109000599 GA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 8628978491

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lad Imaging LLC Past Accepting new patients
Vascular Access Center of Atlanta LLC Vascular & Interventional Radiology Past Accepting new patients
Guardian Medical Services, LLC Past Accepting new patients
Florida United Radiology LC Past Accepting new patients
Gwinnett Clinic LTD Past Accepting new patients
Millennium Health Partners, LLC Specialist PastSince Nov 23, 2004 Accepting new patients
Georgia Health Imaging PastSince Sep 27, 2012 Accepting new patients
Georgia Cancer Specialists I, PC Specialist Past Accepting new patients
Georgia Health Imaging Past Accepting new patients

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205824497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY RD STE 370",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421713",
            "telephone_number": "770-538-1772",
            "fax_number": "770-538-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY RD STE 370",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421713",
            "telephone_number": "770-538-1772",
            "fax_number": "770-538-1773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4519 Woodruff Rd Ste 17",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319046091",
            "country_code": "US",
            "telephone_number": "706-221-8999",
            "fax_number": "706-221-8809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDD",
        "first_name": "DOUGLAS",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "32463",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000755972L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000755972Q",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "1460074",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1609510",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-DMERC GROUP",
            "identifier": "CA9328",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.