Individual provider Active NPI

John P. Erdman, MD

  • Otolaryngology Physician
  • Fort Oglethorpe, GA
National Provider Identifier
1245220128
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
035251 Issued in GA
Practice address
140 Battlewood Dr
Fort Oglethorpe, GA 30742-4006
Phone
(706) 861-7070
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD0000024929 TN
Otolaryngology Physician 207Y00000X 035251 GA Primary

Addresses

Primary practice location

140 Battlewood Dr
Fort Oglethorpe, GA 30742-4006

Mailing address

140 Battlewood Dr
Ft Oglethorpe, GA 30742-4006
Phone (706) 861-7070

Other identifiers 1

IdentifierTypeStateIssuer
00459775BMedicaidGA

Other names 1

  • John P Erdman Professional name

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
I20100517000107 GA Practitioner - Otolaryngology 2668461724 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Oglethorpe, GA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035251GAMDOtolaryngology Physician
MD0000024929TNMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erdman ENT, PC Otolaryngology Past Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 1

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1245220128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BATTLEWOOD DR",
            "city": "FT OGLETHORPE",
            "state": "GA",
            "postal_code": "307424006",
            "telephone_number": "706-861-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BATTLEWOOD DR",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307424006",
            "telephone_number": "706-861-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDMAN",
        "first_name": "JOHN",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "MD0000024929",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "035251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00459775B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "ERDMAN",
            "middle_name": "P",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Oglethorpe, GA

Sources for this page

Verify at the official NPI Registry.