Active NPI
Daniel Rim, MD
- Internal Medicine Physician
- Augusta, GA
National Provider Identifier
1457811085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 100064
- Practice address
- 1120 15TH St # Ad-2226
Augusta, GA 30912-5103 - Phone
- (706) 446-1279
- NPI assigned
- Mar 20, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD480917 | PA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 100064 | GA | Primary |
Addresses
Primary practice location
1120 15TH St # Ad-2226
Augusta, GA 30912-5103
Mailing address
1120 15TH St # Ad-2226
Augusta, GA 30912-0004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230113001864 | MA | Order and Referring Only - Endocrinology | 7911378757 | |
| I20240724004575 | GA | Order and Referring Only - Gastroenterology | 7911378757 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100064 | GA | MD | Internal Medicine Physician |
| MD480917 | PA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1457811085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 15TH ST # AD-2226",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST # AD-2226",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309125103",
"telephone_number": "706-446-1279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIM",
"first_name": "DANIEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-20",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD480917",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "100064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.