Covenant Emergency Physicians LLC
Organization Active NPI Emergency Medicine Physician · Demorest, GA
NPI 1194776914 · NPPES record last updated Sep 13, 2007
Key facts
- NPI
- 1194776914
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- COVENANT EMERGENCY PHYSICIANS LLC
- Practice address
- 541 Historic Hwy 441
ER Department
Demorest, GA 30535 - Phone
- (706) 754-3113
- NPI assigned
- May 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Marc A Chetta, MD
- Title
- President
- Phone
- (706) 754-3113
Practitioners 32
-
James G Hamilton Jr., M.D.
-
John Krowicki, MD
-
Morris Clayton Pulliam, M.D.
-
Ravin Batuk Talati, M.D
-
Kelly Everett Hemphill, PA-C
-
Michael Marien, PA-C
-
Jamie L. Simpson, PA
-
Marc Anthony Chetta, M.D.
-
Steven Alan Durocher, M.D.
-
Cassandra Evans, MD
-
Donald L Fordham, M.D.
-
Joshua L Garrett, M.D.
-
Jason B Hurt, NP-C
-
David I Lubin, MD
-
Sonya Mabry, FNP-C
-
William Lewis McMahon, MD MS
-
Steven J Rector, M.D.
-
Cheryl Evans Shedd, CNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060627000292 | GA | Part B Supplier - Clinic/Group Practice | 8224040712 |
Receives reassigned benefits from 12 practitioners Practice locations: Demorest, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
541 Historic Hwy 441
ER Department
Demorest, GA 30535
Mailing address
480 Barron Dr
Clarkesville, GA 30523-5501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE8501 | Other | GA | RRGA |
Other providers in Demorest, GA
- Centerpoint Counseling & Clinical Services Inc
- Robert C Christmas
- Amelia Kaye Collins
- Kathy Yoho Compton
- John Timothy Cope
- Peyton Crawford
- CRHH-Atl, LLC
- Laura Ann Crone
- Haley Patton Dadd
- Mario N Dalesandro
All providers in Demorest, GA · Emergency Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2007. 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.