NPIMap

Individual provider Active NPI

Johnathan Richard Gore, MD

  • Family Medicine Physician
  • Augusta, GA
National Provider Identifier
1922027283
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36164 Issued in GA
Practice address
3651 Wheeler Rd
Augusta, GA 30909-6521
Phone
(706) 560-2273
Fax
(706) 560-0903
NPI assigned
Jul 18, 2006
Last updated
Aug 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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 36164 GA Primary

Addresses

Primary practice location

3651 Wheeler Rd
Augusta, GA 30909-6521

Mailing address

PO Box 211550
Augusta, GA 30917-1550
Phone (706) 855-9860

Other identifiers 2

IdentifierTypeStateIssuer
000780645DMedicaidGA
36164OtherGAMEDICAL LICENSE

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
I20040730000856 GA Practitioner - Emergency MedicinePractitioner - Family Practice 5294705968 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Medical College of Georgia School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southland Emergency Medical Services Consolidated, LLCGroup PAC ID 4183871320, 48 clinicians
Southland Burke Emergency Medical Services, LLCGroup PAC ID 9537547401, 20 clinicians

Practice addresses (Care Compare)

351 S Liberty St
Waynesboro, GA 30830-9686
Phone (706) 554-4435

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.67 of 100Reported as group
Improvement activities
40
Cost
79.56

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC CurrentSince Sep 1, 2023 Accepting new patients
Au Medical Associates Inc CurrentSince Oct 7, 2014 Accepting new patients
Wellstar MCG Health Warm Springs, Inc. Family Medicine CurrentSince Jul 1, 2015 Accepting new patients
Southland Burke Emergency Medical Services, LLC CurrentSince May 1, 2022 Accepting new patients
Au Medical Associates Inc CurrentSince Oct 7, 2014 Accepting new patients
Wellstar MCG Health Warm Springs, Inc. CurrentSince Jul 1, 2015 Accepting new patients
Peach State Emergency Physicians LLC CurrentSince May 1, 2024 Accepting new patients
Southland Emergency Medical Services Consolidated, LLC Family Medicine CurrentSince May 1, 2022 Accepting new patients
Emergency Coverage, LLC Family Medicine Past Accepting new patients
Karen a Yeh, M.D., LLC Past Accepting new patients
Igor Stojanov,MD,PC Past Accepting new patients

Locations

2258 Wrightsboro Rd
Ste 430
Augusta, GA 30904
Phone (706) 434-0130

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

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

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

610 Sparta Rd
Sandersville, GA 31082
Phone (478) 240-2000

2460 Washington Rd
Thomson, GA 30824
Phone (706) 595-1411

6135 Roosevelt Hwy
Warm Springs, GA 31830
Phone (706) 655-5461

351 S Liberty St
Waynesboro, GA 30830
Phone (706) 554-4435

Organizations & group practices 11

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 5

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1922027283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211550",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309171550",
            "telephone_number": "706-855-9860",
            "fax_number": "706-860-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 WHEELER RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096521",
            "telephone_number": "706-560-2273",
            "fax_number": "706-560-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "JOHNATHAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "36164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000780645D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "36164",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.