Individual provider Active NPI

George M Dodds I, M.D.

  • Internal Medicine Physician
  • Gouverneur, NY
National Provider Identifier
1982644019
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
243767 Issued in NY
Practice address
77 W. Barney St.
Gouverneur, NY 13642
Phone
(315) 287-4440
Fax
(315) 287-1858
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 243767 NY
Pediatric Adolescent Medicine Physician 2080A0000X 243767 NY
Internal Medicine Physician 207R00000X 243767 NY Primary

Addresses

Primary practice location

77 W. Barney St.
Gouverneur, NY 13642

Mailing address

50 Leroy St
Potsdam, NY 13676-1786
Phone (315) 261-6034

Other identifiers 2

IdentifierTypeStateIssuer
01270039MedicaidNY
01995615MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1982644019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-261-6034",
            "fax_number": "315-261-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W. BARNEY ST.",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "13642",
            "telephone_number": "315-287-4440",
            "fax_number": "315-287-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODDS",
        "first_name": "GEORGE",
        "middle_name": "M",
        "name_suffix": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "243767",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "243767",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "243767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01270039",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01995615",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gouverneur, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.