Individual provider Active NPI

John Wayne Ross, MD

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1407955842
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
002280 Issued in GA
Practice address
3915 Cascade Rd SW
Suite 310
Atlanta, GA 30331-8512
Phone
(404) 696-1944
Fax
(404) 696-5705
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 002280 GA Primary

Addresses

Primary practice location

3915 Cascade Rd SW
Suite 310
Atlanta, GA 30331-8512

Mailing address

3915 Cascade Rd SW
Suite 310
Atlanta, GA 30331-8512
Phone (404) 696-1944

Other identifiers 2

IdentifierTypeStateIssuer
000235331FMedicaidGA
000235331AMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050531000892 GA Practitioner - Internal Medicine 5991766503 Reassigns benefits to 1 organization
Practice locations: Atlanta, GA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Duke University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3915 Cascade SWRD
Suite 115
Atlanta, GA 30331-8533
Phone (404) 696-1944

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002280GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Multi Specialty Group CurrentSince Jul 1, 2013 Accepting new patients
Atlanta Multi Specialty Group, PC Past Accepting new patients

Locations

3915 Cascade Rd SW
Ste T-115
Atlanta, GA 30331
Phone (404) 696-1944

Organizations & group practices 2

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1407955842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW",
            "address_2": "SUITE 310",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318512",
            "telephone_number": "404-696-1944",
            "fax_number": "404-696-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW",
            "address_2": "SUITE 310",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318512",
            "telephone_number": "404-696-1944",
            "fax_number": "404-696-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JOHN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "002280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000235331F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000235331A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.