DR. JOHN DAVID IV VICKERY (M.D.) – Allergy & Immunology Physician, NPI 1336364793
Allergy & Immunology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
137 ALLERGY/IMMUNOLOGY in GA
Provider Addresses for DR. JOHN DAVID IV VICKERY (M.D.)
690 DALLAS HWY
SUITE 101
VILLA RICA, GA 301801264
Phone: (770) 459-0620
Type: Mailing
37 CALUMET PKWY
BUILDING F, SUITE 201
NEWNAN, GA 302636734
Phone: (770) 683-4050
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 185 Open Payments records for all available years, with a total value of $6,122.
Total Amount is formed as General ($6,122) + Research ($0) + Ownership ($0) = $6,122.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Blueprint Medicines Corporation ($1,470).
Total Amount
$6,122
General + Research + Ownership
Payments
185
Total payment records
General Amount
$6,122
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Blueprint Medicines Corporation | $1,470 |
| AstraZeneca Pharmaceuticals LP | $880 |
| GENZYME CORPORATION | $700 |
| Regeneron Healthcare Solutions, Inc. | $693 |
| GlaxoSmithKline, LLC. | $677 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-06-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120605000512 | I | Allergy/Immunology | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J2357 | Injection, omalizumab, 5 mg | 6,528 | 15 | $0 |
| 95117 | Professional service for multiple injections of allergen | 1,383 | 155 | $0 |
| 95004 | Test for allergy using allergenic extract | 1,167 | 25 | $0 |
| 96401 | Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle | 261 | 20 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 220 | 148 | $0 |
Insurance plans in this area (ZIP 30180)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ALLERGY/IMMUNOLOGY | GA | 95004 | Injection of allergenic extracts into skin, accessed through the skin | 1359 | 23 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Internal Medicine, Allergy/Immunology | GA | |
| Allergy/Immunology, Internal Medicine | FL | |
| Nurse Practitioner | GA | |
| Physician Assistant | GA | |
| Nurse Practitioner | GA | |
| Allergy/Immunology, Pediatric Medicine | GA | |
| - | GA |
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