Individual provider Active NPI

Juan G Velazquez, D.O.

  • Family Medicine Physician
  • Cordele, GA
National Provider Identifier
1891068227
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
72467 Issued in GA
Practice address
110 E 13TH Ave
Cordele, GA 31015-4245
Phone
(229) 273-0359
Fax
(229) 273-0360
NPI assigned
Feb 15, 2012
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 72467 GA Primary

Addresses

Primary practice location

110 E 13TH Ave
Cordele, GA 31015-4245

Mailing address

110 E 13TH Ave
Cordele, GA 31015-4245
Phone (229) 273-0359

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
I20140923002648 GA Practitioner - Family Practice 8022237049 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erx Group LLCGroup PAC ID 9335037571, 16 clinicians

Practice addresses (Care Compare)

117 Kite Rd
Swainsboro, GA 30401-3231
Phone (248) 972-8725

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72467GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, PC CurrentSince Jul 16, 2017 Accepting new patients
24 On Physicians, P.C. CurrentSince Jul 16, 2017 Accepting new patients
Houston Primary Care Physicians, LLC CurrentSince Jul 14, 2014 Accepting new patients
Houston Primary Care Physicians LLC Family Medicine CurrentSince Jul 14, 2014 Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

233 N Houston Rd
Ste 140E
Warner Robins, GA 31093
Phone (478) 975-6880

Interoperability endpoints

  • Direct secure messaging: juanvelazquez@trh.allscriptsdirect.net

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 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": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1891068227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 13TH AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310154245",
            "telephone_number": "229-273-0359",
            "fax_number": "229-273-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 13TH AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310154245",
            "telephone_number": "229-273-0359",
            "fax_number": "229-273-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "JUAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-15",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "72467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordele, GA

Sources for this page

Verify at the official NPI Registry.