Washington Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

040656 Issued in GA

Legal business name

WASHINGTON INTERNAL MEDICINE LLC

Practice address

22 W Robert Toombs Ave
Washington, GA 30673-1662

Phone

(706) 678-4785

NPI assigned

Jun 9, 2008

Last updated

Oct 28, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kirkland T Dodson, MDNPI 1689745960

Title

Ceo

Phone

(706) 678-4785

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• Kirkland Dodson, MD

  • Internal Medicine Physician
  • Washington, GA
  • NPI 1689745960
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256688000000",
    "number": "1346409927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26040",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312216040",
            "telephone_number": "478-475-1299",
            "fax_number": "478-405-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W ROBERT TOOMBS AVE",
            "city": "WASHINGTON",
            "state": "GA",
            "postal_code": "306731662",
            "telephone_number": "706-678-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "KIRKLAND",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-678-4785",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "040656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Washington, GA
• Providers in Washington, 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 Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.