Individual provider Active NPI

David Arthur Van, M.D.

  • Family Medicine Physician
  • Griffin, GA
National Provider Identifier
1851452254
Registry record updated Nov 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29545 Issued in GA
Practice address
747 S Hill St
Griffin, GA 30224-4830
Phone
(770) 228-5407
Fax
(770) 227-1430
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2014

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 29545 GA Primary

Addresses

Primary practice location

747 S Hill St
Griffin, GA 30224-4830

Mailing address

747 S Hill St
Griffin, GA 30224-4830
Phone (770) 228-5407

Other identifiers 3

IdentifierTypeStateIssuer
00391377AMedicaidGA
2723329P01OtherGACIGNA PROVIDER NUMBER
52023547OtherGABCBS PROVIDER NUMBER

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
I20101005000233 GA Practitioner - Family Practice 2163593187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

726 S 8TH St
Griffin, GA 30224-4827
Phone (770) 228-5407

747 S Hill St
Griffin, GA 30224-4830
Phone (770) 228-5407

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Peachtree City, GA, CCN 117137
  • Wellstar Spalding Medical Center Hospital, Griffin, GA, CCN 110031
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions11
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29545GAMDIntermediate Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Jun 20, 2017 Accepting new patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Jun 20, 2017 Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

747 S Hill St
Griffin, GA 30224
Phone (770) 228-5407

726 S 8th St
Griffin, GA 30224
Phone (770) 228-2273

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: david.van.1@8042.direct.athenahealth.com

Organizations & group practices 2

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 4

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416096000000",
    "number": "1851452254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 S HILL ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244830",
            "telephone_number": "770-228-5407",
            "fax_number": "770-227-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 S HILL ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244830",
            "telephone_number": "770-228-5407",
            "fax_number": "770-227-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "DAVID",
        "middle_name": "ARTHUR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2014-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "29545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00391377A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "2723329P01",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "52023547",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.