Jason Berendt, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

067390 Issued in GA

Practice address

1445 Old McDonough Hwy SE Ste E
Conyers, GA 30094-5977

Phone

(770) 922-9222

NPI assigned

Jun 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

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

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.

• Medical Centre of Conyers

  • Clinic/Center
  • Conyers, GA
  • NPI 1710946371
  Medicare reassignment NPD
• American Current Care PA

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1710168117

  GA

  Medicare reassignment
• Doctors Care, PA

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1366499048

  General Practice

  NPD (past)
• John E. Emmel, MD, PC

  • Geriatric Medicine (Family Medicine) Physician
  • Charleston, SC
  • NPI 1235263534
  NPD (past)
• Lowcountry Medical Associates

  • Internal Medicine Physician
  • Moncks Corner, SC
  • NPI 1790735975
  NPD (past)
• St. Andrews Urgent Care, PC

  • Urgent Care Clinic/Center
  • Charleston, SC
  • NPI 1831416346
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1245266782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 OLD MCDONOUGH HWY SE STE E",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945977",
            "telephone_number": "770-922-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 OLD MCDONOUGH HWY SE STE E",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945977",
            "telephone_number": "770-922-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERENDT",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "23298",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": "23298",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "067390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SC",
            "identifier": "571020809027",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00125604",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232983",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SC",
            "identifier": "571020809032",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Charles Edward Berstecher, OTR/L, ATP, CAPS
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• Between the Pieces

• Internal Medicine Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.