NPIMap

Individual provider Active NPI

Eric E. Jensen, M.D.

  • Internal Medicine Physician
  • Dalton, GA
National Provider Identifier
1235136052
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50304 Issued in GA
Practice address
914 Vista Drive
Dalton, GA 30721-8654
Phone
(706) 226-3139
Fax
(706) 278-6606
NPI assigned
Jul 7, 2005
Last updated
Aug 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50304 GA Primary

Addresses

Primary practice location

914 Vista Drive
Dalton, GA 30721-8654

Mailing address

914 Vista Drive
Dalton, GA 30721-8654
Phone (706) 226-3139

Other identifiers 1

IdentifierTypeStateIssuer
000913393AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040901000490 GA Practitioner - Internal MedicinePractitioner - Emergency Medicine 2860467875 Reassigns benefits to 2 organizations
I20100826000821 GA Practitioner - Internal MedicinePractitioner - Emergency Medicine 2860467875 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Sanford School of Medicine of University of South Dakota, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cornerstone Medical GroupGroup PAC ID 3971575390, 6 clinicians

Practice addresses (Care Compare)

914 Vista Dr
Dalton, GA 30721-8654
Phone 7062263139125

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions20
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50304GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Physician Group Inc CurrentSince Mar 1, 2003 Accepting new patients
Emergency Coverage, LLC Internal Medicine CurrentSince Jul 1, 2005 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Mar 1, 2003 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Ecc Hospitalist Services PC Internal Medicine Past Accepting new patients

Locations

1107 Memorial Dr
Ste 300
Dalton, GA 30720
Phone (706) 226-3139

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1235136052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 VISTA DRIVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218654",
            "telephone_number": "706-226-3139",
            "fax_number": "706-278-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 VISTA DRIVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218654",
            "telephone_number": "706-226-3139",
            "fax_number": "706-278-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "ERIC",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "50304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000913393A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.