David Kavtaradze, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

051148 Issued in GA

Practice address

902 N 7TH St
Cordele, GA 31015-3234

Phone

(229) 276-3100

NPI assigned

Feb 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Internal MedicineAlso: Geriatric Medicine

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Crisp Regional Hospital IncGroup PAC ID 5991616336, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caresouth, an Affiliate of Crisp Reg Hospital Home health agency, Cordele, GA, CCN 117309
• Amedisys Home Health of Macon Home health agency, Macon, GA, CCN 117093
• Crisp Regional Hospice and Palliative Care Hospice, Cordele, GA, CCN 111550
• Crisp Regional Hospital Hospital, Cordele, GA, CCN 110104
• Crisp Regional NSG & Rehab Ctr Nursing home, Cordele, GA, CCN 115568
• Cordele Health and Rehabilitation Nursing home, Cordele, GA, CCN 115429

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.kavtaradze@crispregional.gadirect.net
• Direct secure messaging: david.kavtardze@crispregional.gadirect.net

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Crisp Regional Hospital, Inc

  • Skilled Nursing Facility
  • Cordele, GA
  • NPI 1396711099

  Adp of the SNF, Corporate Director

  CMS ownership

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.

• Crisp Regional Hospital Inc

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• David Kavtaradze MD Inc

  • Internal Medicine Physician
  • Cordele, GA
  • NPI 1386959179
  Medicare reassignment NPD Authorized official
• Crisp Regional Hospital, Inc

  • Long Term Care Pharmacy
  • Cordele, GA
  • NPI 1679836142
  NPD
• Crisp Regional Hospital, Inc

  • Skilled Nursing Facility
  • Cordele, GA
  • NPI 1164855755
  NPD (past)
• Crisp Regional Hospital, Inc

  • Skilled Nursing Facility
  • Cordele, GA
  • NPI 1396711099
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Georgia, L.L.C.

  • Home Health Agency
  • Macon, GA
  • NPI 1356399018
  Care Compare affiliation
• Crisp Regional Hospital Inc

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649
  Care Compare affiliation
• Crisp Regional Hospital, Inc

  • Skilled Nursing Facility
  • Cordele, GA
  • NPI 1164855755

  Nursing home

  Care Compare affiliation
• Crisp Regional Hospital, Inc

  • Skilled Nursing Facility
  • Cordele, GA
  • NPI 1396711099

  Nursing home

  Care Compare affiliation
• Crisp Regional Hospital, Inc

  • Community Based Hospice Care Agency
  • Cordele, GA
  • NPI 1699740498
  Care Compare affiliation
• Crisp Regional Hospital, Inc.

  • Home Health Agency
  • Cordele, GA
  • NPI 1376518118
  Care Compare affiliation

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1376516484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N 7TH STREET",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "31015",
            "telephone_number": "229-271-4608",
            "fax_number": "229-271-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N 7TH ST",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153234",
            "telephone_number": "229-276-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 N 7th Street",
            "address_purpose": "LOCATION",
            "city": "Cordele",
            "state": "GA",
            "postal_code": "31015",
            "country_code": "US",
            "telephone_number": "229-271-4608",
            "fax_number": "229-271-4609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVTARADZE",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "051148",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "051148",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000976214A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Randall W Jordan, OD
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• Kelley Granade Kichler, RD, LD, CNSD
• Kidney Clinic Cordele LLC
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• Internal Medicine Physician in Cordele, GA
• Providers in Cordele, 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 Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.