Active NPI
Robert Wright McKellar, M.D.
- Diagnostic Radiology Physician
- Evans, GA
National Provider Identifier
1578527503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 024709
- Practice address
- 4350 Towne Centre Dr
Suite 1000
Evans, GA 30809-3301 - Phone
- (706) 868-3940
- NPI assigned
- Apr 14, 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 024709 | GA | Primary |
| Diagnostic Neuroimaging (Radiology) Physician | 2085D0003X | 024709 | GA | |
| Body Imaging Physician | 2085B0100X | 024709 | GA | |
| Neuroradiology Physician | 2085N0700X | 024709 | GA | |
| Nuclear Radiology Physician | 2085N0904X | 024709 | GA | |
| Pediatric Radiology Physician | 2085P0229X | 024709 | GA | |
| Diagnostic Ultrasound Physician | 2085U0001X | 024709 | GA |
Addresses
Primary practice location
4350 Towne Centre Dr
Suite 1000
Evans, GA 30809-3301
Mailing address
1125 Troupe St
P.O. Box 3845
Augusta, GA 30914-3845
Phone (706) 737-4575
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265540314 | Other | NPI - BROWN & RADIOLOGY | |
| 00285073C | Medicaid | GA | |
| G02470 | Medicaid | SC | |
| 00285073B | Medicaid | GA | |
| 00285073A | Medicaid | GA | |
| 10059088 | Other | AMERIGROUP | |
| 270819 | Other | GA | BLUE CROSS BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024709 | GA | MD | Pediatric Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evans Imaging, LLC | Past | Accepting new patients | |
| Stephen W. Brown and Radiology Associates of Augusta LLP | Body Imaging | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Radiology Clinic/Center
- Evans, GA
- NPI 1144407750
-
- Diagnostic Radiology Physician
- Augusta, GA
- NPI 1265540314
Body Imaging
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383177600000",
"number": "1578527503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 TROUPE ST",
"address_2": "P.O. BOX 3845",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309143845",
"telephone_number": "706-737-4575",
"fax_number": "706-731-5289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4350 TOWNE CENTRE DR",
"address_2": "SUITE 1000",
"city": "EVANS",
"state": "GA",
"postal_code": "308093301",
"telephone_number": "706-868-3940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKELLAR",
"first_name": "ROBERT",
"middle_name": "WRIGHT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-14",
"last_updated": "2013-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "GA",
"license": "024709",
"primary": true
},
{
"code": "2085D0003X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Neuroimaging",
"state": "GA",
"license": "024709",
"primary": false
},
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "GA",
"license": "024709",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "GA",
"license": "024709",
"primary": false
},
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "GA",
"license": "024709",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "GA",
"license": "024709",
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "GA",
"license": "024709",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI - BROWN & RADIOLOGY",
"identifier": "1265540314",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00285073C",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G02470",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00285073B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00285073A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10059088",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "270819",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evans, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.