Active NPI
Ludwig V Cavaliere, MD
- Nephrology Physician
- Macon, GA
National Provider Identifier
1952300469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 33290
- Practice address
- 640 Martin Luther King Jr Blvd
Suite 200
Macon, GA 31201-3206 - Phone
- (478) 745-5455
- Fax
- (478) 745-2915
- NPI assigned
- Jul 18, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 33290 | GA | Primary |
Addresses
Primary practice location
640 Martin Luther King Jr Blvd
Suite 200
Macon, GA 31201-3206
Mailing address
640 Martin Luther King Jr Blvd
Suite 200
Macon, GA 31201-3206
Phone (478) 745-5455
Other identifiers 22
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000430911M | Medicaid | GA | |
| 110045177 | Other | RAILROAD MEDICARE | |
| 000430911AE | Medicaid | GA | |
| 000430911AF | Medicaid | GA | |
| 000430911H | Medicaid | GA | |
| 000430911AA | Medicaid | GA | |
| 000430911AH | Medicaid | GA | |
| 000430911Z | Medicaid | GA | |
| 000430911G | Medicaid | GA | |
| 000430911Y | Medicaid | GA | |
| 000430911AD | Medicaid | GA | |
| 000430911U | Medicaid | GA | |
| 281691 | Other | BLUECROSS | |
| 000430911N | Medicaid | GA | |
| 000430911S | Medicaid | GA | |
| 000430911AC | Medicaid | GA | |
| 000430911AG | Medicaid | GA | |
| 000430911E | Medicaid | GA | |
| 000430911L | Medicaid | GA | |
| 000430911T | Medicaid | GA | |
| 000430911V | Medicaid | GA | |
| 000430911X | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33290 | GA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297900800000",
"number": "1952300469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 MARTIN LUTHER KING JR BLVD",
"address_2": "SUITE 200",
"city": "MACON",
"state": "GA",
"postal_code": "312013206",
"telephone_number": "478-745-5455",
"fax_number": "478-745-2915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 MARTIN LUTHER KING JR BLVD",
"address_2": "SUITE 200",
"city": "MACON",
"state": "GA",
"postal_code": "312013206",
"telephone_number": "478-745-5455",
"fax_number": "478-745-2915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVALIERE",
"first_name": "LUDWIG",
"middle_name": "V",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-18",
"last_updated": "2011-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "GA",
"license": "33290",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911M",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110045177",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911AE",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911AF",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911H",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911AA",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911AH",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911Z",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911G",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911Y",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911AD",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911U",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS",
"identifier": "281691",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911N",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911S",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911AC",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911AG",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911E",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911L",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911T",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911V",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000430911X",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.