David Kavtaradze MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

051148 Issued in GA

Legal business name

DAVID KAVTARADZE MD INC

Practice address

902 N 7TH St # 100
Cordele, GA 31015-3234

Phone

(229) 276-2286

NPI assigned

Aug 17, 2010

Last updated

Mar 19, 2021By 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

David Kavtaradze, MDNPI 1376516484

Title

Owner

Phone

(229) 271-4608

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

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.

• David Kavtaradze, M.D.

  • Internal Medicine Physician
  • Cordele, GA
  • NPI 1376516484
  Medicare reassignment NPD Authorized official
• Willie Lee Lattimore, N.P.

  • Nurse Practitioner
  • Cordele, GA
  • NPI 1194046961
  NPD
• Melissa Marie Lawrence, D.O.

  • Orthopaedic Surgery Physician
  • Albany, GA
  • NPI 1316169220
  NPD (past)
• Paul A. Michas, M.D.

  • Orthopaedic Surgery Physician
  • Albany, GA
  • NPI 1750355574
  NPD (past)
• Wendy Ann Neveu, M.D./PH.D.

  • Pulmonary Disease Physician
  • Atlanta, GA
  • NPI 1851683072

  Internal Medicine

  NPD (past)
• Stephanie Busby, M.D.

  • Surgery Physician
  • Memphis, TN
  • NPI 1205199197
  NPD (past)
• Vanessa Moll, M.D.

  • Critical Care Medicine (Anesthesiology) Physician
  • Stanford, CA
  • NPI 1346565702
  NPD (past)

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1386959179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N 7TH ST",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153761",
            "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 # 100",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153234",
            "telephone_number": "229-276-2286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Cordele",
            "state": "GA",
            "postal_code": "310153761",
            "country_code": "US",
            "telephone_number": "229-271-4608",
            "fax_number": "229-271-4609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAVID KAVTARADZE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-17",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "KAVTARADZE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-271-4608",
        "authorized_official_credential": "MD"
    },
    "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": "000976214D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crisp Regional Hospital, Inc.
• Crisp Regional Hospital, Inc. (Crisp Regional Community Pharmacy)
• Vincent S Culpepper, MD
• Diana Weaver Curtis, CNM
• Darryl a. Chapman, Sr. DMD
• Ulysses Davila, MD
• Alesha Davis
• Bradley T Davis, NP
• Camie Davis
• Elizabeth Marie Davis, R PH

• 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 Mar 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.