Active NPI
John Joseph Trimble III, MD
- Otolaryngology Physician
- Acworth, GA
National Provider Identifier
1457416570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 030231
- Practice address
- 3540 Cobb Pkwy NW
Acworth, GA 30101 - Phone
- (770) 974-3911
- Fax
- (770) 405-0606
- NPI assigned
- Dec 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 030231 | GA | Primary |
Addresses
Primary practice location
3540 Cobb Pkwy NW
Acworth, GA 30101
Mailing address
1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone (706) 295-5331
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000362403B | Medicaid | GA | |
| 000362403F | Medicaid | GA | |
| 000362403G | Medicaid | GA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241004001243 | GA | Order and Referring Only - Family Practice | 5193629913 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030231 | GA | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321660800000",
"number": "1457416570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1825 MARTHA BERRY BLVD NW",
"city": "ROME",
"state": "GA",
"postal_code": "301651625",
"telephone_number": "706-295-5331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3540 COBB PKWY NW",
"city": "ACWORTH",
"state": "GA",
"postal_code": "30101",
"telephone_number": "770-974-3911",
"fax_number": "770-405-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRIMBLE",
"first_name": "JOHN",
"middle_name": "JOSEPH",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2011-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "GA",
"license": "030231",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000362403B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000362403F",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000362403G",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Acworth, GA
- Deborah Louise Torell, OTR, LPC, LMFT
- Torn Counseling and Recovery Centers, LLC
- Total Comfort Home Care LLC
- Bobby Joel Treadwell Jr., PA-C
- Triinty Psychiatry and Mental Wellness, LLC
- Trinity Palliative Care of Ga
- Trinity Rehabilitation Services, Inc
- Cheryl Ashley Trowell, M.D.
- Shannon Heath Trowell, M.D.
- Konstantin Sergeyevich Tsymbalov, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.