Individual provider Active NPI

Ronald L Hart, MD

  • Family Medicine Physician
  • Dacula, GA
National Provider Identifier
1730185596
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
046115 Issued in GA
Practice address
3685 Braselton Hwy
Suite 100
Dacula, GA 30019-5920
Phone
(678) 546-9800
Fax
(678) 344-8600
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 046115 GA Primary

Addresses

Primary practice location

3685 Braselton Hwy
Suite 100
Dacula, GA 30019-5920

Mailing address

2878 Five Forks Trickum Rd
2A
Lawrenceville, GA 30044-5896
Phone (678) 344-8700

Other identifiers 2

IdentifierTypeStateIssuer
000841882AFMedicaidGA
000841882AIMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20040706000396 GA Practitioner - Family PracticePractitioner - Emergency Medicine 8527045830 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046115GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Emergency Services, Inc. CurrentSince Mar 8, 2012 Accepting new patients
Wellstreet of Georgia PC CurrentSince Dec 11, 2024 Accepting new patients
Reagan Medical Center LLC Family Medicine Current Accepting new patients
Dennis R Thomas MD PC Family Medicine Past Accepting new patients

Locations

485 Highway 29 N
Athens, GA 30601
Phone (706) 353-6000

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

3685 Braselton Hwy
Ste 100
Dacula, GA 30019
Phone (678) 250-0880

2878 Five Forks Trickum Rd
Ste 2A
Lawrenceville, GA 30044
Phone (678) 999-2299

2878 Five Forks Trickum Rd
Lawrenceville, GA 30044
Phone (770) 344-8700

1221 E McPherson Ave
Nashville, GA 31639
Phone (229) 543-7100

5995 Spring St
Warm Springs, GA 31830
Phone (706) 632-4374

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1730185596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2878 FIVE FORKS TRICKUM RD",
            "address_2": "2A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300445896",
            "telephone_number": "678-344-8700",
            "fax_number": "678-377-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3685 BRASELTON HWY",
            "address_2": "SUITE 100",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195920",
            "telephone_number": "678-546-9800",
            "fax_number": "678-344-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "RONALD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "046115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000841882AF",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000841882AI",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.