Individual provider Active NPI

Quitman John Brigmond Jr., LPC

  • Professional Counselor
  • Macon, GA
National Provider Identifier
1013471028
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC009799 Issued in GA
Practice address
144 Pierce Ave
Macon, GA 31204-2860
Phone
(478) 475-4608
Fax
(478) 476-8397
NPI assigned
Jan 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC009799 GA Primary

Addresses

Primary practice location

144 Pierce Ave
Macon, GA 31204-2860

Mailing address

144 Pierce Ave
Macon, GA 31204-2860
Phone (478) 475-4608

Other identifiers 1

IdentifierTypeStateIssuer
LPC009799OtherGALICENSE NUMBER

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240208000790 GA Practitioner - Mental Health Counselor 1456794395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christopher Dennis MD PLLCGroup PAC ID 7416254990, 72 clinicians

Practice addresses (Care Compare)

1420 Milstead Rd NE
Conyers, GA 30012-3823
Phone (888) 515-3834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher Dennis MD PLLC CurrentSince Sep 11, 2024 Accepting new patients
Personal Recovery Network LLC Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

1420 Milstead Rd NE
Conyers, GA 30012
Phone (770) 483-3902

6055 Lakeside Commons Dr
Ste 320
Macon, GA 31210
Phone (478) 238-9344

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Networks

  • FL HMO D-SNP
  • FL HMO
  • FL HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: georgiabehavioralhealthprofessionals.quitmanbrigmond@124220.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1013471028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 PIERCE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042860",
            "telephone_number": "478-475-4608",
            "fax_number": "478-476-8397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 PIERCE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042860",
            "telephone_number": "478-475-4608",
            "fax_number": "478-476-8397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGMOND",
        "first_name": "QUITMAN",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "LPC009799",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.