John David Vickery IV, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

67624 Issued in GA

Practice address

37 Calumet Pkwy
Building F, Suite 201
Newnan, GA 30263-6734

Phone

(770) 683-4050

NPI assigned

Apr 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Allergy/Immunology

Education

University of Tennessee, HSC, College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Allergy and Asthma of Georgia PCGroup PAC ID 2062460785, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

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.

• Center for Allergy & Asthma of Georgia PC

  • Allergy & Immunology Physician
  • Villa Rica, GA
  • NPI 1578504536
  Medicare reassignment Care Compare group NPD
• Center for Allergy and Asthma Southern Crescent

  • Allergy & Immunology Physician
  • Peachtree City, GA
  • NPI 1750902185
  NPD (past)
• Adult Primary Care of Memphis PC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1376738906
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369008000000",
    "number": "1336364793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 DALLAS HWY",
            "address_2": "SUITE 101",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801264",
            "telephone_number": "770-459-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 CALUMET PKWY",
            "address_2": "BUILDING F, SUITE 201",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302636734",
            "telephone_number": "770-683-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERY",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2013-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "44948",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TN",
            "license": "44948",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "67624",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "67624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allergy & Immunology Physician in Newnan, GA
• Providers in Newnan, GA by specialty
• Allergy & Immunology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.