Individual provider Active NPI

Justin McIvor Law, MD

  • Emergency Medicine Physician
  • Macon, GA
National Provider Identifier
1962750323
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
72978 Issued in TN
Practice address
1400 Coleman Ave
Macon, GA 31207-0001
Phone
(478) 301-2700
NPI assigned
Aug 16, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 076754 GA
Emergency Medicine Physician 207P00000X 72978 TN Primary

Addresses

Primary practice location

1400 Coleman Ave
Macon, GA 31207-0001

Mailing address

1400 Coleman Ave
Macon, GA 31207-0001
Phone (478) 301-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170404002559 GA Practitioner - Family Practice 1456343730 Reassigns benefits to 9 organizations
I20240806002036 FL Practitioner - Emergency Medicine 1456343730 Reassigns benefits to 1 organization
I20250512001603 TN Practitioner - Family PracticePractitioner - Emergency Medicine 1456343730 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Southland TN Emergency Medical Services LLCGroup PAC ID 5395267132, 9 clinicians
Emergency Medical Care Facilities PCGroup PAC ID 6103837877, 57 clinicians

Practice addresses (Care Compare)

103 JV Mangubat Dr
Waynesboro, TN 38485-2440
Phone (931) 722-5411

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
  • West Tennessee Healthcare Milan Hospital Hospital, Milan, TN, CCN 440060
  • West Tennessee Healthcare Bolivar Hospital Hospital, Bolivar, TN, CCN 441320
  • Volunteer Community Hospital Hospital, Martin, TN, CCN 440061
  • West Tennessee Healthcare Camden Hospital Hospital, Camden, TN, CCN 441316

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Consolidated Emergency Services, LLC Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Southland Chatuge Emergency Medical Services, LLC Emergency Medicine CurrentSince Sep 2, 2019 Accepting new patients
Southland Optim Screven Emergency Medical Services LLC Emergency Medicine CurrentSince Feb 13, 2017 Accepting new patients
Southland Bainbridge Hospitalist Group, LLC CurrentSince May 6, 2017 Accepting new patients
WT University Medical Associates Inc Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Southland Emergency Medical Services Consolidated, LLC Family Medicine CurrentSince Dec 21, 2018 Accepting new patients
Southland TN Emergency Medical Services LLC Emergency Medicine CurrentSince Apr 25, 2025 Accepting new patients
University of Tennessee Family Medicine Current Accepting new patients
Emergency Medical Care Facilities PC Emergency Medicine CurrentSince May 10, 2025 Accepting new patients
Southland Union Emergency Medical Services, LLC CurrentSince Aug 1, 2019 Accepting new patients
Southland Cochran Emergency Medical Services, LLC Emergency Medicine CurrentSince Oct 2, 2018 Accepting new patients
Southland Emergency Medical Services, L.L.C Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Southland Dodge Emergency Medical Services, LLC Emergency Medicine CurrentSince Aug 24, 2019 Accepting new patients
Small Hospital Innovations LLC Emergency Medicine CurrentSince Jun 15, 2024 Accepting new patients
Wills Memorial Emergency Medical Services, LLC Emergency Medicine Past Accepting new patients
Mercer University School of Medicine Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

524 W Sagamore Ave
Clewiston, FL 33440
Phone (800) 494-3984

1500 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 368-4410

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

35 Hospital Rd
Blairsville, GA 30512
Phone (706) 439-6812

1155 5th St SE
Cairo, GA 39828
Phone (229) 226-3060

90 E Stephens St
Camilla, GA 31730
Phone (229) 200-4950

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

901 Griffin Ave
Eastman, GA 31023
Phone (478) 374-4000

4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527

110 S Main St
Hiawassee, GA 30546
Phone (706) 896-2222

462 Elma G Miles Pkwy
Hinesville, GA 31313
Phone (888) 829-0068

247 S Main St
Reidsville, GA 30453
Phone (478) 787-6255

215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207

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

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

700 W Forest Ave
Fl 5
Jackson, TN 38301
Phone (731) 423-1932

294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932

367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

4039 Highland St
Ste 1
Milan, TN 38358
Phone (731) 723-3668

103 Jv Mangubat Dr
Waynesboro, TN 38485
Phone (931) 722-3404

Organizations & group practices 17

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.

View all 17

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": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1962750323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 COLEMAN AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312070001",
            "telephone_number": "478-301-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 COLEMAN AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312070001",
            "telephone_number": "478-301-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAW",
        "first_name": "JUSTIN",
        "middle_name": "MCIVOR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-16",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "076754",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "72978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.