Individual provider Active NPI

John Wesley Houser III, M.D.

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1760412308
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
019056 Issued in GA
Practice address
2600 Martin Luther King Jr Dr SW
Atlanta, GA 30311-1636
Phone
(404) 699-1353
Fax
(404) 699-5919
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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 019056 GA Primary

Addresses

Primary practice location

2600 Martin Luther King Jr Dr SW
Atlanta, GA 30311-1636

Mailing address

PO Box 70843
Marietta, GA 30007-0843
Phone (404) 699-1353

Other identifiers 1

IdentifierTypeStateIssuer
00160245AMedicaidGA

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
I20050623000183 GA Practitioner - General Practice 8729023445 Reassigns benefits to 1 organization
Practice locations: Atlanta, GA

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Morehouse School of Medicine, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southside Medical Center, Inc.Group PAC ID 6901700723, 12 clinicians

Practice addresses (Care Compare)

1046 Ridge Ave SW
Atlanta, GA 30315-1640
Phone (404) 688-1350

2578 Gresham Rd SE
Atlanta, GA 30316-4138
Phone (404) 241-2336

5139 Jimmy Carter Blvd
Norcross, GA 30093-1680
Phone (770) 613-0070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019056GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Medical Center, Inc. CurrentSince Oct 31, 2016 Accepting new patients
Southside Medical Center, Inc CurrentSince Oct 31, 2016 Accepting new patients
Southside Medical Center, Inc. Past Accepting new patients

Locations

2578 Gresham Rd SE
Atlanta, GA 30316
Phone (404) 241-2336

1039 Ridge Ave SW
Atlanta, GA 30315
Phone (407) 761-8640

Organizations & group practices 3

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 1

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1760412308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70843",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300070843",
            "telephone_number": "404-699-1353",
            "fax_number": "404-699-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MARTIN LUTHER KING JR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303111636",
            "telephone_number": "404-699-1353",
            "fax_number": "404-699-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSER",
        "first_name": "JOHN",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "019056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00160245A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.