Individual provider Active NPI

Vernisha Hearn, M.D.

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1093249807
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
86429 Issued in GA
Practice address
141 Lacy St NW Ste 100
Marietta, GA 30060-1117
Phone
(770) 442-1911
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 86429 GA Primary

Addresses

Primary practice location

141 Lacy St NW Ste 100
Marietta, GA 30060-1117

Mailing address

3400 Old Milton Pkwy Ste C270
Alpharetta, GA 30005-4414
Phone (770) 442-1911

Other practice location 1

3400C Old Milton Pkwy Ste 270
Alpharetta, GA 30005-4438
Phone (770) 442-1911

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
I20210810003045 GA Practitioner - Internal Medicine 5092087890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Practice addresses (Care Compare)

141 Lacy St NW
Suite 100
Marietta, GA 30060-1117
Phone (770) 442-1911

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince May 9, 2021 Accepting new patients

Locations

3400 Old Milton Pkwy
Ste 270
Alpharetta, GA 30005
Phone 7704421911262

3400 Old Milton Pkwy
Ste C270
Alpharetta, GA 30005
Phone 7704421911233

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

141 Lacy St NW
Ste 100
Marietta, GA 30060
Phone (770) 615-1350

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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 and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1093249807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLD MILTON PKWY STE C270",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054414",
            "telephone_number": "770-442-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 LACY ST NW STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601117",
            "telephone_number": "770-442-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400C Old Milton Pkwy Ste 270",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300054438",
            "country_code": "US",
            "telephone_number": "770-442-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEARN",
        "first_name": "VERNISHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "86429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.