Individual provider Active NPI

Brittainy L Dark, M.D.

  • Obstetrics & Gynecology Physician
  • Lawrenceville, GA
National Provider Identifier
1144535790
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
64918 Issued in GA
Practice address
761 Old Norcross Rd
Lawrenceville, GA 30046-4317
Phone
(770) 513-4000
Fax
(770) 995-7563
NPI assigned
Aug 6, 2010
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 64918 GA Primary

Addresses

Primary practice location

761 Old Norcross Rd
Lawrenceville, GA 30046-4317

Mailing address

761 Old Norcross Rd
Lawrenceville, GA 30046-4317
Phone (770) 513-4000

Other identifiers 3

IdentifierTypeStateIssuer
581397572OtherTAX ID #
581799397OtherGAMATERNAL GYNERATIONS PC
997395956AMedicaidGA

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
I20101109000528 GA Practitioner - Obstetrics/Gynecology 6709071392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Morehouse School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Women's Health Group PCGroup PAC ID 1951396639, 61 clinicians

Practice addresses (Care Compare)

600 Professional Dr
Suite 200
Lawrenceville, GA 30046-7651
Phone (770) 513-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64918GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Women's Health Group, P.C. Obstetrics & Gynecology CurrentSince Jul 7, 2021 Accepting new patients
Atlanta Women's Health Group, P.C. CurrentSince Jul 7, 2021 Accepting new patients
Northside Northpoint OB GYN 2 LLC Obstetrics & Gynecology Past Accepting new patients
Northside Hospital, Inc. Past Accepting new patients
Amnestic, LLC Past Accepting new patients
Atlanta Women's Health Group, P.C. Obstetrics & Gynecology Past Accepting new patients
Northside Hospital, Inc. Past Accepting new patients

Locations

2098 Teron Trce
Ste 150
Dacula, GA 30019
Phone (678) 730-1620

600 Professional Dr
Ste 200
Lawrenceville, GA 30046
Phone (770) 513-4000

761 Old Norcross Rd
Lawrenceville, GA 30046
Phone (770) 513-4000

5780 Peachtree Dunwoody Rd
Ste 175
Sandy Springs, GA 30342
Phone (678) 651-2840

5780 Peachtree Dunwoody Rd
Ste 295
Sandy Springs, GA 30342
Phone (404) 255-0621

5780 Peachtree Dunwoody Rd
Ste 300
Sandy Springs, GA 30342
Phone (404) 252-1137

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.

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": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1144535790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464317",
            "telephone_number": "770-513-4000",
            "fax_number": "770-995-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464317",
            "telephone_number": "770-513-4000",
            "fax_number": "770-995-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARK",
        "first_name": "BRITTAINY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-06",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "64918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "581397572",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MATERNAL GYNERATIONS PC",
            "identifier": "581799397",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "997395956A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.