Individual provider Active NPI

Taiwanna Granae Brown-Bolds, M.D.

  • Internal Medicine Physician
  • Rome, GA
National Provider Identifier
1104911817
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
046047 Issued in GA
Practice address
123 Three Rivers Dr NE
Rome, GA 30161-2300
Phone
(706) 295-3961
NPI assigned
Oct 4, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 046047 GA Primary

Addresses

Primary practice location

123 Three Rivers Dr NE
Rome, GA 30161-2300

Mailing address

420 E 2ND Ave Ste 103
Rome, GA 30161-3210
Phone (706) 509-3000

Other practice location 1

1301 Well Brook Circle
Conyers, GA 30012-3873
Phone (770) 922-3023

Other identifiers 1

IdentifierTypeStateIssuer
00838142AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbrownbolds914761@CarolinasHealthcareSystem.direct-ci.com

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
I20051118000112 GA Practitioner - Internal Medicine 1557380581 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Morehouse School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

1025 N Main St
Cedartown, GA 30125-2036
Phone (770) 748-5212

123 Three Rivers Nedr
Rome, GA 30161-2300
Phone (706) 295-3961

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.9 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046047GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates of Rockdale PC Internal Medicine Current Accepting new patients
Floyd Healthcare Management Inc CurrentSince Jul 1, 2021 Accepting new patients
Floyd Healthcare Management Inc Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Internal Medicine & Wellness Center of Ga LLC Internal Medicine CurrentSince Jun 27, 2011 Accepting new patients
Brown Family Health Center LLC Past Accepting new patients

Locations

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

1301 Wellbrook Cir NE
Conyers, GA 30012
Phone (404) 922-3023

123 Three Rivers Dr NE
Rome, GA 30161
Phone (706) 295-3961

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

4 Savannah St
Winder, GA 30680
Phone (770) 586-0017

Interoperability endpoints

  • Direct secure messaging: tbrownbolds914761@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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 5

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104911817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE STE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613210",
            "telephone_number": "706-509-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 THREE RIVERS DR NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301612300",
            "telephone_number": "706-295-3961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Well Brook Circle",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300123873",
            "country_code": "US",
            "telephone_number": "770-922-3023",
            "fax_number": "770-929-1016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN-BOLDS",
        "first_name": "TAIWANNA",
        "middle_name": "GRANAE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "046047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00838142A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbrownbolds914761@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "N",
            "address_1": "123 Three Rivers Dr NE",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301612300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.