Individual provider Active NPI

Adrienne Simone Berard, M.D.

  • Internal Medicine Physician
  • Carrollton, GA
National Provider Identifier
1972594166
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
039288 Issued in GA
Practice address
101 Doctors Dr
Carrollton, GA 30117-4486
Phone
(770) 834-6208
Fax
(770) 830-7620
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 039288 GA Primary

Addresses

Primary practice location

101 Doctors Dr
Carrollton, GA 30117-4486

Mailing address

101 Doctors Dr
Carrollton, GA 30117-4486
Phone (770) 834-6208

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
I20100215000294 GA Practitioner - Internal Medicine 3577607589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mercer University School of Medicine, 1993
Medicare assignment
May accept Medicare assignment
Group practices
West Georgia Internal Medicine PCGroup PAC ID 9133114457, 7 clinicians

Practice addresses (Care Compare)

101 Doctors Dr
Carrollton, GA 30117-4486
Phone (770) 834-6208

706 Dixie St
Suite 300
Carrollton, GA 30117-3819

Hospital & facility affiliations

  • Tanner Home Health Services Home health agency, Carrollton, GA, CCN 117319
  • Centerwell Home Health Home health agency, Peachtree City, GA, CCN 117137
  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
  • Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015
  • Higgins General Hospital Hospital, Bremen, GA, CCN 111320

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039288GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Georgia Internal Medicine PC Internal Medicine CurrentSince Jul 1, 1998 Accepting new patients

Locations

101 Doctors Dr
Carrollton, GA 30117
Phone (770) 812-8863

706 Dixie St
Ste 300
Carrollton, GA 30117
Phone (770) 834-6208

Organizations & group practices 1

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.

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1972594166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DOCTORS DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174486",
            "telephone_number": "770-834-6208",
            "fax_number": "770-830-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DOCTORS DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174486",
            "telephone_number": "770-834-6208",
            "fax_number": "770-830-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERARD",
        "first_name": "ADRIENNE",
        "middle_name": "SIMONE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "039288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.