Individual provider Active NPI

Jeremy Romine, PA

  • Physician Assistant
  • Ringgold, GA
National Provider Identifier
1457626111
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.9686 Issued in GA
Practice address
7566 Nashville St
Ringgold, GA 30736-2361
Phone
(706) 935-3600
NPI assigned
Mar 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.9686 GA Primary

Addresses

Primary practice location

7566 Nashville St
Ringgold, GA 30736-2361

Mailing address

601 S Harbour Island Blvd Ste 200
Tampa, FL 33602-5925
Phone (800) 480-5243

Other practice location 1

3257 Chattanooga Vly Rd
Flintstone, GA 30725-2387
Phone (706) 841-7800

Other practice location 2

106 Pearl Dr
LA Fayette, GA 30728-7509
Phone (706) 620-0200

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200407003861 GA Practitioner - Physician Assistant 9234456690 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Landw Medical Services LLCGroup PAC ID 4385165927, 5 clinicians

Practice addresses (Care Compare)

6553 Hwy 41
Ringgold, GA 30736-2641
Phone (706) 965-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.9686GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gordon Emergency Physicians, LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 6

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": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1457626111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "800-480-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7566 NASHVILLE ST",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362361",
            "telephone_number": "706-935-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3257 Chattanooga Vly Rd",
            "address_purpose": "LOCATION",
            "city": "Flintstone",
            "state": "GA",
            "postal_code": "307252387",
            "country_code": "US",
            "telephone_number": "706-841-7800",
            "fax_number": "706-841-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Pearl Dr",
            "address_purpose": "LOCATION",
            "city": "LA Fayette",
            "state": "GA",
            "postal_code": "307287509",
            "country_code": "US",
            "telephone_number": "706-620-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMINE",
        "first_name": "JEREMY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-14",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "PA.9686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ringgold, GA

Sources for this page

Verify at the official NPI Registry.