NPIMap

Individual provider Active NPI

Rodney J Avery, M.D.

  • Internal Medicine Physician
  • Gainesville, GA
National Provider Identifier
1710140132
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125052097 Issued in IL
Practice address
743 Spring Street
Gainesville, GA 30501-1267
Phone
(770) 219-6000
Fax
(770) 219-6021
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125052097 IL Primary

Addresses

Primary practice location

743 Spring Street
Gainesville, GA 30501-1267

Mailing address

1405 Jesse Jewell Parkway
Gainesville, GA 30501-3806
Phone (770) 219-7826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111024000292 GA Practitioner - Internal MedicinePractitioner - Other (Physician) 7719038934 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Louisville School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Regional Physicians Management Group, LLCGroup PAC ID 9032491956, 27 clinicians
Covenant Medical Group LLCGroup PAC ID 4082969241, 17 clinicians

Practice addresses (Care Compare)

11 Upper Riverdale Rd SW
Women'S Center
Riverdale, GA 30274-2615
Phone (770) 991-8000

483 Upper Riverdale Rd SW
Suite L
Riverdale, GA 30274-2579
Phone (770) 742-3883

705 Juniper St NE
Atlanta, GA 30308-1307
Phone (770) 742-3883

Hospital & facility affiliations

  • Southern Regional Medical Center Hospital, Riverdale, GA, CCN 110165
  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079
  • Douglasville Center for Nursing and Healing LLC Nursing home, Douglasville, GA, CCN 115273

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125052097ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince Jan 25, 2016 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince Jan 25, 2016 Accepting new patients
Covenant Medical Group LLC CurrentSince Feb 1, 2023 Accepting new patients
Georgia Hospitalists Group, LLC Current Accepting new patients
Southern Regional Physicians Management Group, LLC CurrentSince Apr 8, 2017 Accepting new patients
Prime Healthcare Foundation - Southern Regional, LLC Past Accepting new patients
Bleckley Emergency Group LLC Past Accepting new patients
Douglasville Nursing and Rehabilitation Center, LLC Past Accepting new patients

Locations

2360 Rockmart Hwy
Cedartown, GA 30125
Phone (770) 748-2500

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

11 Upper Riverdale Rd SW
Ste 21
Riverdale, GA 30274

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

483 Upper Riverdale Rd SW
Ste L
Riverdale, GA 30274
Phone (770) 742-3883

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1710140132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 JESSE JEWELL PARKWAY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806",
            "telephone_number": "770-219-7826",
            "fax_number": "770-219-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING STREET",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011267",
            "telephone_number": "770-219-6000",
            "fax_number": "770-219-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "RODNEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125052097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.