NPIMap

Individual provider Active NPI

John David Rowe Jr., PHYSICIAN ASSISTANT

  • Physician Assistant
  • Willacoochee, GA
National Provider Identifier
1891815924
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
003941 Issued in GA
Practice address
134 Fleetwood Ave E
Willacoochee, GA 31650-2730
Phone
(912) 534-5142
Fax
(912) 534-6120
NPI assigned
Mar 30, 2007
Last updated
Apr 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 003941 GA Primary

Addresses

Primary practice location

134 Fleetwood Ave E
Willacoochee, GA 31650-2730

Mailing address

710 N Irwin Ave
Ocilla, GA 31774-5011
Phone (229) 468-3800

Other identifiers 1

IdentifierTypeStateIssuer
100002799FMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050714000773 GA Practitioner - Physician Assistant 7911933593 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Georgia School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Irwin County HospitalGroup PAC ID 7618950643, 8 clinicians
Ich Physician GroupGroup PAC ID 9537592084, 5 clinicians
Southland Consolidated Emergency Services LLCGroup PAC ID 2860792066, 68 clinicians
Southland Optim Screven Emergency Medical Services LLCGroup PAC ID 9739480021, 19 clinicians

Practice addresses (Care Compare)

134 Fleetwood Ave E
Willacoochee, GA 31650-2730
Phone (912) 534-5142

1500 E Shotwell St
Bainbridge, GA 39819-4256
Phone (229) 246-3500

163 S Tallahassee St
Hazlehurst, GA 31539-6465
Phone (912) 375-7781

710 N Irwin Ave
Ocilla, GA 31774-5011
Phone 22946838003846

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003941GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ich Physician Group CurrentSince Jan 1, 2020 Accepting new patients
Coffee Regional Medical Center, Inc CurrentSince Apr 1, 2011 Accepting new patients
Ich Physician Group Current Accepting new patients
Coffee Regional Medical Center CurrentSince Apr 1, 2011 Accepting new patients
Ich Physician Group Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Med Cross Imaging LLC Past Accepting new patients

Locations

1101 Ocilla Rd
Douglas, GA 31533
Phone (912) 383-5641

357 Cargile Rd
Ocilla, GA 31774
Phone (229) 468-3800

710 N Irwin Ave
Ocilla, GA 31774
Phone (229) 468-3800

134 Fleetwood Ave E
Willacoochee, GA 31650
Phone (912) 384-3338

Interoperability endpoints

  • Direct secure messaging: john.rowe@irwincohosp.gadirect.net

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1891815924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N IRWIN AVE",
            "city": "OCILLA",
            "state": "GA",
            "postal_code": "317745011",
            "telephone_number": "229-468-3800",
            "fax_number": "229-468-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 FLEETWOOD AVE E",
            "city": "WILLACOOCHEE",
            "state": "GA",
            "postal_code": "316502730",
            "telephone_number": "912-534-5142",
            "fax_number": "912-534-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWE",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002799F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willacoochee, GA

Sources for this page

Verify at the official NPI Registry.