Individual provider Active NPI

Amber Cathleen Dodgen, MD

  • Pediatrics Physician
  • Columbus, GA
National Provider Identifier
1336438845
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
89210 Issued in GA
Practice address
3702 2ND Ave
Columbus, GA 31904-7408
Phone
(706) 507-9209
NPI assigned
Apr 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 89210 GA Primary

Addresses

Primary practice location

3702 2ND Ave
Columbus, GA 31904-7408

Mailing address

3702 2ND Ave
Columbus, GA 31904-7408
Phone (706) 507-9209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89210GAMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: amber.dodgen.1@8710.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1336438845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 2ND AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319047408",
            "telephone_number": "706-507-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 2ND AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319047408",
            "telephone_number": "706-507-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGEN",
        "first_name": "AMBER",
        "middle_name": "CATHLEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "89210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.