Active NPI
Jason McGovern, DMD
- Dentist
- Tifton, GA
National Provider Identifier
1487690160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN013320
- Practice address
- 1413 Tift Ave N
Tifton, GA 31794-3546 - Phone
- (229) 382-0803
- Fax
- (229) 382-0809
- NPI assigned
- Jun 21, 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN013320 | GA | Primary |
Addresses
Primary practice location
1413 Tift Ave N
Tifton, GA 31794-3546
Mailing address
PO Box 1349
Tifton, GA 31793-1349
Phone (229) 382-0803
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN013320 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487690160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1349",
"city": "TIFTON",
"state": "GA",
"postal_code": "317931349",
"telephone_number": "229-382-0803",
"fax_number": "229-382-0809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1413 TIFT AVE N",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943546",
"telephone_number": "229-382-0803",
"fax_number": "229-382-0809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGOVERN",
"first_name": "JASON",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN013320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tifton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.