NPIMap

Organization Active NPI

Cartersville Urgent Care LLC

  • Emergency Medicine Physician
  • Cartersville, GA
National Provider Identifier
1316986227
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CARTERSVILLE URGENT CARE LLC
Practice address
824 West Ave
Cartersville, GA 30120-6100
Phone
(678) 721-5570
NPI assigned
Jun 6, 2006
Last updated
Jun 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Authorized official

Name
Jeff Rydburg
Title
VP
Phone
(615) 373-7600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X GA Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

824 West Ave
Cartersville, GA 30120-6100

Mailing address

824 West Ave
Cartersville, GA 30120-6100
Phone (678) 721-5570

Other identifiers 3

IdentifierTypeStateIssuer
5837030001OtherSCMEDICARE DME
52230467001OtherGABCBS OF GA
823710629AMedicaidGA

National Provider Directory

National Provider Directory

Locations

824 West Ave
Cartersville, GA 30120
Phone (678) 721-5570

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1316986227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 WEST AVE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301206100",
            "telephone_number": "678-721-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 WEST AVE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301206100",
            "telephone_number": "678-721-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTERSVILLE URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "RYDBURG",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "615-373-7600"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "5837030001",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GA",
            "identifier": "52230467001",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "823710629A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.