Ira Steven Racadag, APRN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Mountain City, GA
NPI 1922540277 · NPPES record last updated Nov 4, 2024
Key facts
- NPI
- 1922540277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- RN264829 (GA)
- Practice address
- 95 Golden Hills Dr. Ste. D
Mountain City, GA 30562-2025 - Phone
- (706) 613-4485
- Fax
- (762) 212-4368
- NPI assigned
- Nov 16, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abundant Life Psychiatric Services, LLC | Current |
Accepting new patients | |
| L & P Services, Inc. | Single Specialty | Past | Accepting new patients |
| Chatuge Regional Hospital Inc | Single Specialty | Past | Accepting new patients |
| Pfeifer Counseling, Consulting and Training LLC | Single Specialty | Past | Accepting new patients |
Interoperability endpoints
- ira.racadag.1@30480.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | RN264829 | GA | Yes |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN11015334 | FL |
Addresses
Primary practice location
95 Golden Hills Dr. Ste. D
Mountain City, GA 30562-2025
Mailing address
125 N Main St Unit 1170
Clayton, GA 30525-4698
Phone (706) 613-4485
Other providers in Mountain City, GA
All providers in Mountain City, GA · Psychiatric/Mental Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.