Active NPI
Foster Blake Brin, M.D.
- Psychologist
- Macon, GA
National Provider Identifier
1083701312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 29980
- Practice address
- 175 Emery Highway
Macon, GA 31217 - Phone
- (478) 751-4446
- Fax
- (478) 751-4444
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 29980 | GA | Primary |
Addresses
Primary practice location
175 Emery Highway
Macon, GA 31217
Mailing address
175 Emery Highway
Macon, GA 31217
Phone (478) 751-4446
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29980 | Other | GA | M.D. |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29980 | GA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083701312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 EMERY HIGHWAY",
"city": "MACON",
"state": "GA",
"postal_code": "31217",
"telephone_number": "478-751-4446",
"fax_number": "478-751-4444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 EMERY HIGHWAY",
"city": "MACON",
"state": "GA",
"postal_code": "31217",
"telephone_number": "478-751-4446",
"fax_number": "478-751-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIN",
"first_name": "FOSTER",
"middle_name": "BLAKE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "29980",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "M.D.",
"identifier": "29980",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.