Individual provider Active NPI

Drew Garrett Hundertmark, DO

  • Family Medicine Physician
  • Fort Benning, GA
National Provider Identifier
1952975765
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
93754 Issued in GA
Practice address
6600 Van Aaist Blvd
Fort Benning, GA 31905
Phone
(762) 408-2532
NPI assigned
May 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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 93754 GA Primary

Addresses

Primary practice location

6600 Van Aaist Blvd
Fort Benning, GA 31905

Mailing address

Unit 28037 Box PSC 411
Apo, AE 09112-8037

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
I20221206002995 GA Order and Referring Only - Family PracticePractitioner - Family Practice 8123497500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93754GAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1952975765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "UNIT 28037 BOX PSC 411",
            "city": "APO",
            "state": "AE",
            "postal_code": "091128037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AAIST BLVD",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "31905",
            "telephone_number": "762-408-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNDERTMARK",
        "first_name": "DREW",
        "middle_name": "GARRETT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "93754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Benning, GA

Sources for this page

Verify at the official NPI Registry.