Individual provider Active NPI

Richard Ackermann, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Macon, GA
National Provider Identifier
1467428128
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
034759 Issued in GA
Practice address
3780 Eisenhower Pkwy
Macon, GA 31206-0800
Phone
(478) 633-5500
Fax
(478) 784-3550
NPI assigned
Feb 23, 2006
Last updated
Sep 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 034759 GA
Geriatric Medicine (Family Medicine) Physician 207QG0300X 034759 GA Primary

Addresses

Primary practice location

3780 Eisenhower Pkwy
Macon, GA 31206-0800

Mailing address

3780 Eisenhower Pkwy
Macon, GA 31206-0800
Phone (478) 633-5500

Other identifiers 2

IdentifierTypeStateIssuer
000478035HMedicaidGA
000478035IMedicaidGA

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
I20060418000404 GA Practitioner - Family PracticePractitioner - Geriatric Medicine 3476562539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Duke University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Services of Central GeorgiaGroup PAC ID 9638076730, 300 clinicians

Practice addresses (Care Compare)

1120 Morningside Dr
Perry, GA 31069-2906
Phone (478) 987-3600

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
034759GAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical Center of Central Georgia Inc CurrentSince Jan 1, 2001 Accepting new patients
Health Services of Central Georgia, Inc Family Medicine CurrentSince Mar 1, 2006 Accepting new patients
The Medical Center of Central Georgia Inc. Current Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients

Locations

3400 Riverside Dr
Macon, GA 31210
Phone (478) 474-5600

770 Pine St
Ste 140
Macon, GA 31201
Phone (478) 633-1821

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

Interoperability endpoints

  • Direct secure messaging: rackermann433827@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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 1

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1467428128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 EISENHOWER PKWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312060800",
            "telephone_number": "478-633-5500",
            "fax_number": "478-784-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3780 EISENHOWER PKWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312060800",
            "telephone_number": "478-633-5500",
            "fax_number": "478-784-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMANN",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "034759",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "034759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000478035H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000478035I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.