Arthur J Provisor, MD

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

047358 Issued in GA

Practice address

1800 10TH Ave
Columbus, GA 31901

Phone

(706) 571-1120

Fax

(706) 660-1603

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MPPG, Inc.

  • Family Medicine Physician
  • Savannah, GA
  • NPI 1033131172

  Pediatric Hematology-Oncology

  Medicare reassignment NPD
• Central Georiga Fertility Institute

  • Reproductive Endocrinology Physician
  • Macon, GA
  • NPI 1447390901
  NPD (past)
• Health Services of Central Georgia, Inc

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Pediatric Hematology-Oncology

  NPD (past)
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1902976152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 WATERS AVE STE 103",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046267",
            "telephone_number": "912-350-5646",
            "fax_number": "912-350-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 10TH AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31901",
            "telephone_number": "706-571-1120",
            "fax_number": "706-660-1603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319011513",
            "country_code": "US",
            "telephone_number": "706-571-1120",
            "fax_number": "706-660-1603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4750 Waters Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046267",
            "country_code": "US",
            "telephone_number": "912-350-8180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROVISOR",
        "first_name": "ARTHUR",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "GA",
            "license": "047358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00834655B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Project Rebound Inc.
• Project Rebound Inc.
• Promax Medical Center LLC
• Jennifer Prophitt
• Will McKinnley Prothro
• Porsche Prowell, BS
• Amanda Barnette Pruett
• Pruitthealth Home Health - South Atlanta, Inc.
• Tara Psalmond
• Psychiatric Services at Brookstone, PC

• Pediatric Hematology & Oncology Physician in Columbus, GA
• Providers in Columbus, GA by specialty
• Pediatric Hematology & Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.