Individual provider Active NPI

David Bruce Brantley, MD

  • Emergency Medicine Physician
  • Claxton, GA
National Provider Identifier
1104879931
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
028506 Issued in GA
Practice address
200 N River St
Claxton, GA 30417-1659
Phone
(912) 882-4870
NPI assigned
May 19, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 028506 GA Primary

Addresses

Primary practice location

200 N River St
Claxton, GA 30417-1659

Mailing address

200 Corporate Blvd
Suite 201
Lafayette, LA 70508-3870
Phone (800) 893-9698

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
I20041022000634 GA Practitioner - Emergency Medicine 1557322534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors to Go LLCGroup PAC ID 4688114416, 17 clinicians

Practice addresses (Care Compare)

200 N River St
Claxton, GA 30417-1659
Phone (912) 739-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ben Hill Emergency Group LLC Emergency Medicine CurrentSince Feb 26, 2014 Accepting new patients
Doctors to Go, LLC Emergency Medicine CurrentSince Jun 9, 2024 Accepting new patients
Liberty Emergency Group LLC Emergency Medicine Past Accepting new patients
Dodge Emergency Group LLC Emergency Medicine Past Accepting new patients

Locations

200 N River St
Claxton, GA 30417
Phone (912) 739-2611

200 Perry House Rd
Fitzgerald, GA 31750
Phone (229) 424-1461

200 Corporate Blvd
Ste 201
Lafayette, LA 70508

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104879931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N RIVER ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171659",
            "telephone_number": "912-882-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "DAVID",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "028506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claxton, GA

Sources for this page

Verify at the official NPI Registry.