Active NPI
Craig Underset, M.D.
- Family Medicine Physician
- Smyrna, GA
National Provider Identifier
1477519965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 029961
- Practice address
- 562 Concord Rd SE
Smyrna, GA 30082-2608 - Phone
- (770) 384-9900
- NPI assigned
- Apr 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 029961 | GA | Primary |
Addresses
Primary practice location
562 Concord Rd SE
Smyrna, GA 30082-2608
Mailing address
562 Concord Rd SE
Smyrna, GA 30082-2608
Phone (770) 384-9900
Other practice location 1
562 Concord Rd SE
Smyrna, GA 30082-2608
Phone (770) 384-9900
Other practice location 2
5579 Mableton Pkwy SE
Mableton, GA 30126-3301
Phone (770) 948-1049
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160905879B | Medicaid | GA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cunderset108641@directwellstar.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579737600000",
"number": "1477519965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "562 CONCORD RD SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300822608",
"telephone_number": "770-384-9900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "562 CONCORD RD SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300822608",
"telephone_number": "770-384-9900"
}
],
"practiceLocations": [
{
"address_1": "562 Concord Rd SE",
"address_purpose": "LOCATION",
"city": "Smyrna",
"state": "GA",
"postal_code": "300822608",
"country_code": "US",
"telephone_number": "770-384-9900",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5579 Mableton Pkwy SE",
"address_purpose": "LOCATION",
"city": "Mableton",
"state": "GA",
"postal_code": "301263301",
"country_code": "US",
"telephone_number": "770-948-1049",
"fax_number": "770-948-6522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UNDERSET",
"first_name": "CRAIG",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-24",
"last_updated": "2020-01-23",
"certification_date": "2020-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "029961",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "160905879B",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cunderset108641@directwellstar.org",
"affiliation": "N",
"address_1": "562 Concord Rd SE",
"city": "Smyrna",
"state": "GA",
"country_code": "US",
"postal_code": "300822608",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.