Lifebrite Hospital Group of Early LLC
Organization Active NPI Emergency Care Clinic/Center · Blakely, GA
NPI 1194258129 · NPPES record last updated Aug 23, 2023
Key facts
- NPI
- 1194258129
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Care Clinic/Center 261QE0002X
- Legal business name
- LIFEBRITE HOSPITAL GROUP OF EARLY LLC
- Practice address
- 11740 Columbia St
Blakely, GA 39823-2574 - Phone
- (229) 723-4841
- NPI assigned
- Apr 6, 2017
- Organization subpart
- No
Authorized official
- Name
- Morgan Dunn
- Title
- Ceo
- Phone
- (601) 849-6440
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 5
Practitioners 32
-
Vincent B. Barker, M.D.
-
Glendell B. Coleman, FNP-C
-
Julie Tiner Trawick, NURSE PRACTITIONER
-
Russell Gerald Gelormini, D.O.
-
Susan A. Gootnick, M.D.
-
Philip B. McDonald, M.D.
-
David Lamar Brand Jr., M.D.
-
Luis Alberto Murrain, D.O.
-
Zacharey Alan Powell, DNP, FNP-C
-
Dennis M Burton, M.D.
-
Parveen Kumar, M.D.
-
Dean V Moesch, M.D.
-
Justin Hung Pham, M.D.
-
Scott E. Preusen, M.D.
-
Michael K. Rushing, FNP-BC
-
Amit Kumar Sanghi, D.O.
-
Stamey Seleste Cook, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171024003011 | GA | Part B Supplier - Clinic/Group Practice | 7810263589 |
Receives reassigned benefits from 30 practitioners 1 other NPI on this enrollment Practice locations: Blakely, GA |
National Provider Directory
- Tax ID family
- Lifebrite Hosp GRP of Early
Locations
11045 Columbia St
Blakely, GA 39823
Phone (228) 723-4313
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Care Clinic/Center | 261QE0002X | Yes |
Addresses
Primary practice location
11740 Columbia St
Blakely, GA 39823-2574
Mailing address
11740 Columbia St
Blakely, GA 39823-2574
Other names
- Early Emergency Care
Other providers in Blakely, GA
- Allison Josey
- Brooklyn Lane
- Chandra Levatte
- Rachel Lewis
- Lifebrite Hospital Group of Early LLC
- Lifebrite Hospital Group of Early LLC
- Lifebrite Hospital Group of Early LLC
- Lifebrite Hospital Group of Early LLC
- Lifebrite Hospital Group of Early LLC
- Lifebrite Hospital Group of Early LLC
All providers in Blakely, GA · Emergency Care Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.