Individual provider Active NPI

Evelyn Campbell-Bayaan, M.D.

  • Family Medicine Physician
  • Morrow, GA
National Provider Identifier
1013274109
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
72561 Issued in GA
Practice address
1331 Mount Zion Rd
Morrow, GA 30260
Phone
(770) 629-3217
NPI assigned
Apr 13, 2012
Last updated
Oct 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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 72561 GA Primary

Addresses

Primary practice location

1331 Mount Zion Rd
Morrow, GA 30260

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117

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
I20160712002991 GA Practitioner - Family Practice 5092007005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PMR Georgia Holding LLCGroup PAC ID 8426466590, 19 clinicians

Practice addresses (Care Compare)

2124 Candler Rd
Decatur, GA 30032-5572
Phone (404) 836-0272

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72561GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Georgia Holding, LLC CurrentSince Jan 9, 2023 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310
Phone (404) 419-0184

3371 Buford Hwy NE
Brookhaven, GA 30329
Phone (404) 419-0180

2124 Candler Rd
Decatur, GA 30032
Phone (404) 836-0272

2084 Headland Dr
East Point, GA 30344
Phone (404) 419-0184

1331 Mount Zion Rd
Morrow, GA 30260
Phone (404) 419-0184

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1013274109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 MOUNT ZION RD",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "30260",
            "telephone_number": "770-629-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL-BAYAAN",
        "first_name": "EVELYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "72561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

Verify at the official NPI Registry.