Individual provider Active NPI

Bryan D Ross, DO

  • Internal Medicine Physician
  • Douglasville, GA
National Provider Identifier
1245750900
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
85462 Issued in GA
Practice address
7135 Creeksong Dr
Douglasville, GA 30134-7072
Phone
(434) 799-2055
NPI assigned
Jun 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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 85462 GA Primary

Addresses

Primary practice location

7135 Creeksong Dr
Douglasville, GA 30134-7072

Mailing address

7135 Creeksong Dr
Douglasville, GA 30134-7072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20201013000356 SC Practitioner - Internal Medicine 2567733751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lincoln Memorial University Medical Department, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85462GAMDInternal Medicine Physician
83342SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Regional Medical Center of the Pee Dee, Inc Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 1, 2020 Accepting new patients
Danville Patient Care, Inc. Internal Medicine PastSince Jan 1, 2007 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc. Past Accepting new patients

Locations

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1245750900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7135 CREEKSONG DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301347072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7135 CREEKSONG DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301347072",
            "telephone_number": "434-799-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "BRYAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-23",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "85462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.