Individual provider Active NPI

Jean P McDonough, MD

  • Obstetrics & Gynecology Physician
  • Augusta, GA
National Provider Identifier
1902900624
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
056154 Issued in GA
Practice address
1430 Harper St
BLDG a
Augusta, GA 30901
Phone
(706) 724-2261
Fax
(706) 724-2523
NPI assigned
Sep 12, 2006
Last updated
Jun 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 056154 GA Primary

Addresses

Primary practice location

1430 Harper St
BLDG a
Augusta, GA 30901

Mailing address

1348 Walton Way
Ste 4100
Augusta, GA 30901-5107
Phone (706) 724-2261

Other identifiers 1

IdentifierTypeStateIssuer
720005146AMedicaidGA

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
I20050519000100 GA Practitioner - Obstetrics/Gynecology 8527057363 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Georgia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OBGYN Partners of Augusta, Professional CorporationGroup PAC ID 1153302914, 23 clinicians

Practice addresses (Care Compare)

1348 Walton Way
Suite 4100
Augusta, GA 30901-5107
Phone (706) 722-1381

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
056154GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrics and Gynecology Associates of Augusta, PC Obstetrics & Gynecology Current Accepting new patients
Au Medical Associates Inc CurrentSince Jul 16, 2017 Accepting new patients
Augusta University CurrentSince Jul 16, 2017 Accepting new patients
Au Medical Associates Inc CurrentSince Jul 16, 2017 Accepting new patients
University Health Services,Inc Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1430 Harper St
Ste A
Augusta, GA 30901
Phone (706) 724-2261

997 Saint Sebastian Way
Augusta, GA 30912
Phone (706) 721-3141

Organizations & group practices 6

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1902900624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 WALTON WAY",
            "address_2": "STE 4100",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309015107",
            "telephone_number": "706-724-2261",
            "fax_number": "706-724-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 HARPER ST",
            "address_2": "BLDG A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30901",
            "telephone_number": "706-724-2261",
            "fax_number": "706-724-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "JEAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "056154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "720005146A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.