Individual provider Active NPI

Ralph Dumas, CSA

  • Surgical Physician Assistant
  • McDonough, GA
National Provider Identifier
1689873069
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2973 Issued in GA
Practice address
4305 Gladys CT
McDonough, GA 30252-3703
Phone
(770) 985-4257
Fax
(770) 985-4258
NPI assigned
Jul 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2973 GA Primary

Addresses

Primary practice location

4305 Gladys CT
McDonough, GA 30252-3703

Mailing address

4305 Gladys CT
McDonough, GA 30252-3703
Phone (770) 985-4257

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2973GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1689873069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 GLADYS CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302523703",
            "telephone_number": "770-985-4257",
            "fax_number": "770-985-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 GLADYS CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302523703",
            "telephone_number": "770-985-4257",
            "fax_number": "770-985-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMAS",
        "first_name": "RALPH",
        "credential": "CSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "2973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.