Patrick D Retterbush MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PATRICK D RETTERBUSH MD LLC

Practice address

1500 Oglethorpe Ave Ste 300a
Athens, GA 30606-2181

Phone

(706) 614-1750

Fax

(706) 480-4185

NPI assigned

Dec 13, 2018

Organization subpart

No

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

Authorized official

Name

Elizabeth Retterbush

Title

Administrator

Phone

(706) 255-3702

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 5

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

• Scott W Craven, PA-C

  • Physician Assistant
  • Gainesville, GA
  • NPI 1457863839
  Medicare reassignment Care Compare group
• Patrick David Retterbush, M.D.

  • MOHS-Micrographic Surgery Physician
  • Athens, GA
  • NPI 1700176211
  Medicare reassignment Care Compare group
• Morgan Leigh Arnold, MD

  • Dermatology Physician
  • Athens, GA
  • NPI 1760988513
  Medicare reassignment
• Paul L Haun, M.D.

  • Dermatology Physician
  • Peachtree City, GA
  • NPI 1881980738
  Medicare reassignment
• Lauren S Nagashima-Whalen, MD

  • Dermatology Physician
  • Athens, GA
  • NPI 1033172382
  Medicare reassignment

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

{
    "created_epoch": "1544659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559001600000",
    "number": "1700357019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE STE 300A",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062181",
            "telephone_number": "706-614-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE STE 300A",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062181",
            "telephone_number": "706-614-1750",
            "fax_number": "706-480-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK D RETTERBUSH MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-13",
        "last_updated": "2019-05-28",
        "status": "A",
        "authorized_official_last_name": "RETTERBUSH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "706-255-3702"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "practiceadministrator@udscc.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "documents",
            "address_1": "1500 Oglethorpe Ave Ste 300",
            "city": "Athens",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306062179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sejal Patel, O.D.
• Shyam Jayesh Patel
• Path of Wellness, Inc
• Pathology and Laboratory Consultants of Athens LLC
• Shashikant Patil, M.D
• James Benjamin Patrick, DMD
• Emory Garrett Patterson, M.D.
• Lauren Zeagler Patterson, RN
• Stephen Roger Patterson, NCPRSS
• Jonathan M. Patton, M.D.

• Dermatology Physician in Athens, GA
• Providers in Athens, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.