Individual provider Active NPI

Jacob Ward, MD

  • Pain Medicine Physician
  • Canton, GA
National Provider Identifier
1336224260
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
32075 Issued in GA
Practice address
2000 Village Professional Dr Ste 200
Canton, GA 30114-8499
Phone
(678) 661-4545
Fax
(678) 880-8151
NPI assigned
Oct 26, 2006
Last updated
Feb 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32075 GA
Pain Medicine Physician 208VP0000X 32075 GA Primary

Addresses

Primary practice location

2000 Village Professional Dr Ste 200
Canton, GA 30114-8499

Mailing address

2000 Village Professional Dr Ste 200
Canton, GA 30114-8499
Phone (678) 661-4545

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
I20040706000760 GA Practitioner - Family Practice 1355325887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2000 Village Professional Dr
Suite 200
Canton, GA 30114-8499
Phone (678) 661-4545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32075GAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob Ward MD, LLC Single Specialty CurrentSince Jun 14, 2004 Accepting new patients
Georgia Physician Associates PC Single Specialty CurrentSince Feb 1, 2014 Accepting new patients
Georgia Physician Associates, PC Single Specialty Current Accepting new patients
Georgia Physician Associates PC CurrentSince Feb 1, 2014 Accepting new patients
Surgery Center Anesthesia Providers PC Single Specialty PastSince Dec 15, 2011 Accepting new patients
Wellstar Medical Group, LLC Single Specialty Past Accepting new patients

Locations

5745 Old Winder Hwy
Ste C
Braselton, GA 30517
Phone (770) 450-6350

2000 Village Professional Dr
Ste 200
Canton, GA 30114
Phone (678) 245-6244

1200 Buckhead Xing
Ste B
Woodstock, GA 30189
Phone (770) 592-4350

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1336224260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 VILLAGE PROFESSIONAL DR STE 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148499",
            "telephone_number": "678-661-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 VILLAGE PROFESSIONAL DR STE 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148499",
            "telephone_number": "678-661-4545",
            "fax_number": "678-880-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "32075",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "32075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.