NPIMap

Individual provider Active NPI

George G Mygatt, M.D.

  • Urology Physician
  • Douglasville, GA
National Provider Identifier
1740239730
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
020462 Issued in GA
Practice address
6002 Professional Pkwy
Suite 280
Douglasville, GA 30134-5600
Phone
(770) 942-5227
Fax
(770) 489-7589
NPI assigned
May 8, 2006
Last updated
Oct 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 020462 GA Primary

Addresses

Primary practice location

6002 Professional Pkwy
Suite 280
Douglasville, GA 30134-5600

Mailing address

6002 Professional Pkwy
Suite 280
Douglasville, GA 30134-5600
Phone (770) 942-5227

Other identifiers 1

IdentifierTypeStateIssuer
000281872AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gmygatt61892@directwellstar.org

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
I20051027000249 GA Practitioner - Urology 0446277859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical College of Georgia School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

4904 Timber Ridge Dr
Douglasville, GA 30135-1831

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Urology CurrentSince Jan 20, 2014 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jan 20, 2014 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

6002 Professional Pkwy
Ste 280
Douglasville, GA 30134
Phone (770) 428-3995

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

55 Whitcher St NE
Ste 250
Marietta, GA 30060
Phone (770) 428-3995

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.

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1740239730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 PROFESSIONAL PKWY",
            "address_2": "SUITE 280",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345600",
            "telephone_number": "770-942-5227",
            "fax_number": "770-489-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6002 PROFESSIONAL PKWY",
            "address_2": "SUITE 280",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345600",
            "telephone_number": "770-942-5227",
            "fax_number": "770-489-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYGATT",
        "first_name": "GEORGE",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "020462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000281872A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmygatt61892@directwellstar.org",
            "affiliation": "N",
            "address_1": "6002 Professional Pkwy",
            "address_2": "Suite 280",
            "city": "Douglasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301345600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.