Active NPI
Janice K. Bain, M.D.
- Internal Medicine Physician
- Mableton, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 056967
- Practice address
- 4885 Collins Lake Dr
Mableton, GA 30126-1794 - Phone
- (470) 725-2496
- NPI assigned
- Oct 17, 2005
- Last updated
- Jan 13, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD60452100 | WA | |
| Internal Medicine Physician | 207R00000X | 056967 | GA | Primary |
Addresses
Primary practice location
4885 Collins Lake Dr
Mableton, GA 30126-1794
Mailing address
4885 Collins Lake Dr
Mableton, GA 30126-1794
Phone (470) 725-2496
Other practice location 1
820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Permanente Medical Group |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
750 Townpark LN NW
Kennesaw, GA 30144-5579
Phone (770) 514-5405
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056967 | GA | MD | Internal Medicine Physician |
| MD60452100 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Southeast Permanente Medical Group | Internal Medicine | Current | Accepting new patients |
| Cooperative Healthcare Services Inc | Internal Medicine | Current | Accepting new patients |
| Emergency Coverage Services, PC | Past | Accepting new patients | |
| Wellstar Physicians Group Douglas Hospitalists, LLC | Internal Medicine | Past | Accepting new patients |
| Emergency Coverage, LLC | Internal Medicine | Past | Accepting new patients |
| York Physician Services PC | Past | Accepting new patients | |
| Ecc Hospitalist Services PC | Internal Medicine | Past | Accepting new patients |
Locations
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079
750 Townpark Ln NW
Kennesaw, GA 30144
Phone (770) 514-5401
5665 Ptree Dunwoody Rd NE
Sandy Springs, GA 30342
Phone (678) 843-7001
Organizations & group practices 7
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1245266956
-
dba Southeast Georgia Physician Associates
- Clinic/Center
- Brunswick, GA
- NPI 1417979402
Internal Medicine
-
- Internal Medicine Physician
- Douglasville, GA
- NPI 1376590463
-
- Nurse Practitioner
- Lawrenceburg, TN
- NPI 1053351593
-
dba Emergency Coverage Corporation of TeamHealth
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
Internal Medicine
-
- Hospitalist Physician
- Rock Hill, SC
- NPI 1588898795
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1679664395
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642032000000",
"number": "1093704645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4885 COLLINS LAKE DR",
"city": "MABLETON",
"state": "GA",
"postal_code": "301261794",
"telephone_number": "470-725-2496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4885 COLLINS LAKE DR",
"city": "MABLETON",
"state": "GA",
"postal_code": "301261794",
"telephone_number": "470-725-2496"
}
],
"practiceLocations": [
{
"address_1": "820 N Chelan Ave",
"address_purpose": "LOCATION",
"city": "Wenatchee",
"state": "WA",
"postal_code": "988012028",
"country_code": "US",
"telephone_number": "509-663-8711",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAIN",
"first_name": "JANICE",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-17",
"last_updated": "2022-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD60452100",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "056967",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "5665 Peachtree Dunwoody Rd",
"city": "Atlanta",
"state": "GA",
"country_code": "US",
"postal_code": "303421764",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mableton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.