Mary Jean East, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

063187 Issued in GA

Practice address

539 Hardee St
Dallas, GA 30132-4711

Phone

(770) 505-0531

Fax

(770) 485-0570

NPI assigned

Apr 10, 2006

Last updated

Aug 8, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Dr. Mary Jean East Professional name

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

Specialty

Family Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Home Health, LLC Home health agency, Marietta, GA, CCN 117102
• Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• East Clinic LLC

  dba The East Clinic, LLC

  • Family Medicine Physician
  • Dallas, GA
  • NPI 1831563261
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cobb Hospital, Inc

  dba Wellstar Cobb Hospital

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Paulding Medical Center, Inc.

  dba Wellstar Paulding Hospital

  • General Acute Care Hospital
  • Hiram, GA
  • NPI 1457329435
  Care Compare affiliation
• Wellstar Home Health, LLC

  dba WellStar Home Health

  • Home Health Agency
  • Marietta, GA
  • NPI 1073591376
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1225091341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 HARDEE ST",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324711",
            "telephone_number": "770-505-0531",
            "fax_number": "770-485-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 HARDEE ST",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324711",
            "telephone_number": "770-505-0531",
            "fax_number": "770-485-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAST",
        "first_name": "MARY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN032537",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "063187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000430515A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085000588G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "EAST",
            "middle_name": "JEAN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ariel Kristin Dyches, PHARMD
• E&E Reliable Transportation LLC
• Lee H. Eades, MSN, FNP-C
• Patrice Early, LCSW
• East Clinic LLC (The East Clinic, LLC)
• Rita Owenaze Edosomwan
• April Edwards-Arnold
• Cassandra Edwards, MS, OTR/L
• Chloe Edwards
• Ehi Pharmacy Solutions, LLC.

• Family Medicine Physician in Dallas, GA
• Providers in Dallas, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.