Kevin C Dellsperger, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

071064 Issued in GA

Practice address

1120 15TH Street
Augusta, GA 30912-0004

Phone

(706) 724-6100

NPI assigned

May 13, 2006

Last updated

Dec 11, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Curators of the University of Missouri

  dba Mizzou Pharmacy - Southwest Blvd

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1740083641
  NPD (past)
• The Curators of the University of Missouri

  dba University Physicians Specialty Care Associates

  • Eyewear Supplier
  • Columbia, MO
  • NPI 1770662785
  NPD (past)

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1407807662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 WALTON WAY",
            "address_2": "SUITE 1400",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012602",
            "telephone_number": "706-724-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH STREET",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-724-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLSPERGER",
        "first_name": "KEVIN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "071064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003141162B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "GA1581",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Eladio Deleon, D.M.D.
• Eladio Deleon Jr., DMD, MS
• Gabriela Marie Delgado, OTR/L
• William Delk
• Shannon Nisha Dellen, MD
• Tara Pettit Deloach, LMFT
• Alexis Jean Delousia
• James Demedici, RN
• Oksana Maria Demediuk, MD
• Meredith Koehler Dempsey

• Cardiovascular Disease Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.