Individual provider Active NPI

Daulton E Todd Jr., MD

  • Internal Medicine Physician
  • Cumming, GA
National Provider Identifier
1447285770
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
029116 Issued in GA
Practice address
418 Pirkle Ferry Rd
Suite 103
Cumming, GA 30040-2529
Phone
(770) 781-6373
Fax
(770) 781-6381
NPI assigned
Jul 12, 2006
Last updated
Jun 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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 029116 GA Primary

Addresses

Primary practice location

418 Pirkle Ferry Rd
Suite 103
Cumming, GA 30040-2529

Mailing address

PO Box 1739
Cumming, GA 30028-1739
Phone (770) 781-6373

Other identifiers 1

IdentifierTypeStateIssuer
000344858BMedicaidGA

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
I20080528000711 GA Practitioner - Internal Medicine 8123198595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

418 Pirkle Ferry Rd
Suite 103
Cumming, GA 30040-2529
Phone (770) 781-6373

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029116GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daulton E Todd Jr MD PC Internal Medicine CurrentSince Jul 15, 2001 Accepting new patients
Chronic Disease Management of Georgia, LLC CurrentSince Jul 10, 2024 Accepting new patients
Gold City Health & Rehab LLC Past Accepting new patients

Locations

418 Pirkle Ferry Rd
Ste 103
Cumming, GA 30040
Phone (770) 781-6373

704 Breedlove Dr
#A
Monroe, GA 30655
Phone (888) 772-0076

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1447285770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1739",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300281739",
            "telephone_number": "770-781-6373",
            "fax_number": "770-781-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 PIRKLE FERRY RD",
            "address_2": "SUITE 103",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402529",
            "telephone_number": "770-781-6373",
            "fax_number": "770-781-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "DAULTON",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "029116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000344858B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.