Individual provider Active NPI

Jay Alan Erdman, M.D.

  • Emergency Medicine Physician
  • Newnan, GA
National Provider Identifier
1700874864
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E91398 Issued in GA
Practice address
60 Hospital Rd
Newnan, GA 30263-1210
Phone
(800) 532-6151
Fax
(770) 251-7873
NPI assigned
Oct 12, 2005
Last updated
Nov 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E91398 GA Primary

Addresses

Primary practice location

60 Hospital Rd
Newnan, GA 30263-1210

Mailing address

PO Box 5661
Athens, GA 30604-5661
Phone (706) 354-5770

Other identifiers 1

IdentifierTypeStateIssuer
000428315JMedicaidGA

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E91398GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emerginet, LLC PastSince Jul 1, 2001 Accepting new patients
Parkway Anesthesia Consultants, PC Past Accepting new patients
Northside Cherokee Urgent Care, LLC Emergency Medicine Past Accepting new patients
Emerginet Henry, LLC Past Accepting new patients

Organizations & group practices 4

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1700874864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5661",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306045661",
            "telephone_number": "706-354-5770",
            "fax_number": "706-354-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HOSPITAL RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631210",
            "telephone_number": "800-532-6151",
            "fax_number": "770-251-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDMAN",
        "first_name": "JAY",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "E91398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000428315J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.