NPIMap

Individual provider Active NPI

Justin D Lovvorn, MD

  • Family Medicine Physician
  • Bowdon, GA
National Provider Identifier
1871703868
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
062249 Issued in GA
Practice address
1125 E Highway 166
Bowdon, GA 30108-2401
Phone
(770) 258-5424
NPI assigned
May 22, 2007
Last updated
Jun 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 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 062249 GA Primary

Addresses

Primary practice location

1125 E Highway 166
Bowdon, GA 30108-2401

Mailing address

119 Ambulance Dr
Suite 202
Carrollton, GA 30117-3857
Phone (770) 836-9250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091222000447 GA Practitioner - Family Practice 1355481375 Reassigns benefits to 3 organizations
I20120919000849 AL Practitioner - Family Practice 1355481375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Alabama School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Primary Care of Wedowee IncGroup PAC ID 8426211905, 3 clinicians
Tanner Medical Center Alabama IncGroup PAC ID 6507123726, shared by 3 NPIs, 4 clinicians
TMC West Carroll Family Healthcare Center IncGroup PAC ID 5991616039, 3 clinicians

Practice addresses (Care Compare)

1030 Main St S
Wedowee, AL 36278-7440
Phone (256) 357-2188

1032 Main St S
Wedowee, AL 36278-7440
Phone (256) 357-2111

1125 E Hwy 166
Bowden, GA 30108-2401
Phone (770) 258-5424

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Primary Care of Wedowee Inc Family Medicine CurrentSince Aug 20, 2012 Accepting new patients
Tanner Medical Group Inc Family Medicine CurrentSince Mar 23, 2020 Accepting new patients
TMC Tallapoosa Family Healthcare Center Family Medicine CurrentSince May 1, 2015 Accepting new patients
TMC West Carroll Family Healthcare Center Inc Family Medicine CurrentSince Oct 10, 2009 Accepting new patients
TMC Haralson Family Healthcare Center Family Medicine Past Accepting new patients

Locations

1030 Main St S
Wedowee, AL 36278
Phone (256) 357-2188

1125 E Highway 166
Bowdon, GA 30108
Phone (770) 258-5424

119 Ambulance Dr
Ste 202
Carrollton, GA 30117
Phone (770) 838-8710

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

2906 Franklin Pkwy
Franklin, GA 30217
Phone (706) 675-6949

25 W Lyon St
Tallapoosa, GA 30176
Phone (770) 812-2800

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

Organizations & group practices 5

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 9

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1871703868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR",
            "address_2": "SUITE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-836-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E HIGHWAY 166",
            "city": "BOWDON",
            "state": "GA",
            "postal_code": "301082401",
            "telephone_number": "770-258-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVVORN",
        "first_name": "JUSTIN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "062249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowdon, GA

Sources for this page

Verify at the official NPI Registry.