Individual provider Active NPI

Dawit Weldemichael, M.D.

  • Psychiatry Physician
  • Rome, GA
National Provider Identifier
1386836583
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
075710 Issued in GA
Practice address
304 Shorter Ave NW Ste 104
Rome, GA 30165-4256
Phone
(706) 232-5650
NPI assigned
Aug 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 075710 GA
Psychiatry Physician 2084P0800X 075710 GA Primary

Addresses

Primary practice location

304 Shorter Ave NW Ste 104
Rome, GA 30165-4256

Mailing address

420 E 2ND Ave Ste 103
Rome, GA 30161-3210
Phone (706) 509-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150714001620 FL Practitioner - Psychiatry 1759565179 Reassigns benefits to 1 organization
I20161019000103 GA Practitioner - PsychiatryPractitioner - Sleep Medicine 1759565179 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
075710GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hakim LLC CurrentSince Feb 17, 2017 Accepting new patients
Floyd Physicians, LLC Psychiatry CurrentSince Oct 1, 2016 Accepting new patients
TBJ Behavioral Center LLC Psychiatry CurrentSince Mar 1, 2015 Accepting new patients
Advanced Recovery Systems, LLC Past Accepting new patients
Advanced Psychiatric Services Inc Psychiatry PastSince Jun 16, 2014 Accepting new patients
Advanced Psychiatric Services Psychiatry Past Accepting new patients
Advanced Recovery Systems, LLC Past Accepting new patients

Locations

400 Northwood Dr
Centre, AL 35960
Phone (256) 927-1382

6300 Beach Blvd
Jacksonville, FL 32216
Phone (904) 724-9202

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

304 Shorter Ave NW
Ste 104
Rome, GA 30165
Phone (706) 232-5650

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

4245 Johns Creek Pkwy
Ste E
Suwanee, GA 30024
Phone (678) 456-8000

4245 Johns Creek Pkwy
Ste 4
Suwanee, GA 30024
Phone (678) 456-8000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1386836583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE STE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613210",
            "telephone_number": "706-509-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 SHORTER AVE NW STE 104",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301654256",
            "telephone_number": "706-232-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDEMICHAEL",
        "first_name": "DAWIT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "GA",
            "license": "075710",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "075710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.