Individual provider Active NPI

Richard A Wherry, MD

  • Family Medicine Physician
  • Dahlonega, GA
National Provider Identifier
1679558126
Registry record updated Nov 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
017341 Issued in GA
Practice address
59 Tipton Dr
Dahlonega, GA 30533-1603
Phone
(706) 864-4012
Fax
(706) 864-4029
NPI assigned
Dec 7, 2005
Last updated
Nov 25, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 017341 GA Primary

Addresses

Primary practice location

59 Tipton Dr
Dahlonega, GA 30533-1603

Mailing address

PO Box 1449
Dahlonega, GA 30533-0025
Phone (706) 864-4012

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
I20090303000339 GA Practitioner - Family Practice 0345306130 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17341GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Diagnostics LLC Current Accepting new patients
Community Primary Care of Georgia LLC CurrentSince Mar 1, 2018 Accepting new patients
Allergy and ENT of Ga Family Medicine Past Accepting new patients
Georgia Heart Institute LLC PastSince Jan 8, 2018 Accepting new patients

Locations

1005 Boulder Dr
Gray, GA 31032
Phone (478) 621-2072

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1679558126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305330025",
            "telephone_number": "706-864-4012",
            "fax_number": "706-864-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 TIPTON DR",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305331603",
            "telephone_number": "706-864-4012",
            "fax_number": "706-864-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHERRY",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "017341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dahlonega, GA

Sources for this page

Verify at the official NPI Registry.