NPIMap

Organization Active NPI

West Georgia Infectious Diseases

  • Infectious Disease Physician
  • Austell, GA
National Provider Identifier
1881768117
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
WEST GEORGIA INFECTIOUS DISEASES
Doing business as
West Georgia Infectious Diseases
Practice address
1700 Hospital South Dr
Suite 402
Austell, GA 30106
Phone
(770) 739-8282
Fax
(770) 739-0794
NPI assigned
Nov 20, 2006
Last updated
Jul 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Ms. Kathryn Marie Shiver
Title
Office Manager
Phone
(770) 739-8282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X Primary

Addresses

Primary practice location

1700 Hospital South Dr
Suite 402
Austell, GA 30106

Mailing address

1700 Hospital South Dr
Suite 402
Austell, GA 30106
Phone (770) 739-8282

Other names 1

  • West Georgia Infectious Diseases Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000334 GA Part B Supplier - Clinic/Group Practice 0244228559 Receives reassigned benefits from 2 practitioners
Practice locations: Austell, GA

National Provider Directory

National Provider Directory

Locations

1700 Hospital South Dr
Ste 402
Austell, GA 30106
Phone (770) 739-8282

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1881768117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR",
            "address_2": "SUITE 402",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "30106",
            "telephone_number": "770-739-8282",
            "fax_number": "770-739-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR",
            "address_2": "SUITE 402",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "30106",
            "telephone_number": "770-739-8282",
            "fax_number": "770-739-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA INFECTIOUS DISEASES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "SHIVER",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-739-8282",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Georgia Infectious Diseases",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.