Organization Active NPI

Daulton E Todd Jr MD PC

  • Internal Medicine Physician
  • Cumming, GA
National Provider Identifier
1588049977
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
029116 Issued in GA
Legal business name
DAULTON E TODD JR MD PC
Practice address
418 Pirkle Ferry Rd
Ste 103
Cumming, GA 30040-2529
Phone
(770) 781-6373
Fax
(770) 781-6381
NPI assigned
Jul 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Authorized official

Name
Daulton E Todd Jr., MDNPI 1447285770
Title
Owner/Proprietor
Phone
(770) 781-6373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 029116 GA Primary

Addresses

Primary practice location

418 Pirkle Ferry Rd
Ste 103
Cumming, GA 30040-2529

Mailing address

418 Pirkle Ferry Rd
Ste 103
Cumming, GA 30040-2529
Phone (770) 781-6373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151209001017 GA Part B Supplier - Clinic/Group Practice 7719288158 Receives reassigned benefits from 1 practitioner
Practice locations: Cumming, GA

National Provider Directory

National Provider Directory

Locations

418 Pirkle Ferry Rd
Ste 103
Cumming, GA 30040
Phone (770) 781-6373

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437955200000",
    "number": "1588049977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 PIRKLE FERRY RD",
            "address_2": "STE 103",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402529",
            "telephone_number": "770-781-6373",
            "fax_number": "770-781-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 PIRKLE FERRY RD",
            "address_2": "STE 103",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402529",
            "telephone_number": "770-781-6373",
            "fax_number": "770-781-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAULTON E TODD JR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A",
        "authorized_official_last_name": "TODD",
        "authorized_official_first_name": "DAULTON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/PROPRIETOR",
        "authorized_official_telephone_number": "770-781-6373",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "029116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.