Individual provider Active NPI

Adam Joseph Barefoot, D.M.D.

  • Dentist
  • Palmetto, GA
National Provider Identifier
1447561501
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
014049 Issued in GA
Practice address
643 Main St
Palmetto, GA 30268-1138
Phone
(770) 463-4644
Fax
(770) 463-9885
NPI assigned
Jun 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 014049 GA Primary
Dentist 122300000X 18629 FL

Addresses

Primary practice location

643 Main St
Palmetto, GA 30268-1138

Mailing address

643 Main St
Palmetto, GA 30268-1138
Phone (404) 929-8824

Other identifiers 1

IdentifierTypeStateIssuer
003119045AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18629FLMDDentist
014049GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1447561501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 MAIN ST",
            "city": "PALMETTO",
            "state": "GA",
            "postal_code": "302681138",
            "telephone_number": "404-929-8824",
            "fax_number": "404-929-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 MAIN ST",
            "city": "PALMETTO",
            "state": "GA",
            "postal_code": "302681138",
            "telephone_number": "770-463-4644",
            "fax_number": "770-463-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAREFOOT",
        "first_name": "ADAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "014049",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "18629",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003119045A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto, GA

Sources for this page

Verify at the official NPI Registry.