NPIMap

Organization Active NPI

Allergy and ENT of Ga

  • Family Medicine Physician
  • Dahlonega, GA
National Provider Identifier
1205919404
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALLERGY AND ENT OF GA
Doing business as
Allergy and ENT of GA
Practice address
227 Mountain Dr
Dahlonega, GA 30533-1606
Phone
(706) 867-4306
Fax
(706) 864-1356
NPI assigned
Oct 23, 2006
Last updated
Jun 30, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHERN HEALTH CORPORATION OF DAHLONEGAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Authorized official

Name
Mr. Larry R Jeter
Title
Ceo
Phone
(706) 867-4311

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

227 Mountain Dr
Dahlonega, GA 30533-1606

Mailing address

PO Box 1449
Dahlonega, GA 30533-0025
Phone (706) 864-1356

Other names 1

  • Allergy and ENT of GA Doing business as

National Provider Directory

National Provider Directory
Part of
Southern Health Corp

Locations

227 Mountain Dr
Dahlonega, GA 30533
Phone (706) 864-6136

70 Mountain Dr
Ste C
Dahlonega, GA 30533
Phone (706) 867-0145

278 Highway 400 N
Ste 1160
Dawsonville, GA 30534
Phone (706) 265-8439

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1205919404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305330025",
            "telephone_number": "706-864-1356",
            "fax_number": "706-864-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MOUNTAIN DR",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305331606",
            "telephone_number": "706-867-4306",
            "fax_number": "706-864-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY AND ENT OF GA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN HEALTH CORPORATION OF DAHLONEGA",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "JETER",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-867-4311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allergy and ENT of GA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dahlonega, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.