George L Ivey III, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD14169 Issued in TN

Practice address

701 County Services Dr
Cookeville, TN 38501-4338

Phone

(931) 528-2531

Fax

(931) 526-7453

NPI assigned

Oct 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• State of Tennessee

  • Public Health or Welfare Agency
  • Jasper, TN
  • NPI 1487791315
  Medicare reassignment NPD
• State of Tennessee

  • Public Health or Welfare Agency
  • Springfield, TN
  • NPI 1316090145
  NPD
• State of Tennessee

  • Public Health or Welfare Agency
  • Cookeville, TN
  • NPI 1598817017
  NPD

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720076342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 ENGLAND DR",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010924",
            "telephone_number": "931-520-4466",
            "fax_number": "931-520-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 COUNTY SERVICES DR",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014338",
            "telephone_number": "931-528-2531",
            "fax_number": "931-526-7453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1503 S Main St",
            "address_purpose": "LOCATION",
            "city": "Crossville",
            "state": "TN",
            "postal_code": "385555967",
            "country_code": "US",
            "telephone_number": "931-484-6196",
            "fax_number": "931-456-1047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVEY",
        "first_name": "GEORGE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD 14169",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "MD14169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innovative Family Care, PLLC
• Ipart Families, LLC
• Terah C Isaacson, M.D.
• Isd Renal Inc
• Itzsebbyyy LLC
• Kristi Michelle Jackson, MA, LPC-MHSP
• Michelle Jackson, MSN, FNP-C
• Nevia Jackson
• Robin Jacob, MD
• Cierra Jacobson

• General Practice Physician in Cookeville, TN
• Providers in Cookeville, TN by specialty
• General Practice Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.