Justin Flynn Harrell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

59162 Issued in GA

Practice address

200 Doctors Drive
Suite 106
Douglas, GA 31533-2203

Phone

(912) 384-3338

Fax

(912) 384-8214

NPI assigned

Apr 4, 2007

Last updated

May 20, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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 PracticeAlso: Emergency Medicine

Education

Medical College of Georgia School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coffee Regional Medical Center IncGroup PAC ID 4587656012, 29 clinicians

Douglas Medical SpecialistGroup PAC ID 6204868862, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Waycross, GA, CCN 117076
• Centerwell Home Health Home health agency, Homerville, GA, CCN 117073
• Coffee Regional Medical Center, Inc Hospital, Douglas, GA, CCN 110089

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21809/brand/1/csg/1/fhir/r4
• Direct secure messaging: justin.harrell@4247.securemail.prognocis.com

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.

• Coffee Regional Medical Center, Inc

  • Anesthesiology Physician
  • Douglas, GA
  • NPI 1437120946
  Medicare reassignment Care Compare group NPD
• Douglas Medical Specialist

  • Cardiovascular Disease Physician
  • Douglas, GA
  • NPI 1154475085
  Medicare reassignment Care Compare group NPD
• 24 On Physicians, PC

  • Hospitalist Physician
  • Rome, GA
  • NPI 1912956251
  Medicare reassignment NPD
• Bethany Hospice and Palliative Care of Coastal Georgia, LLC

  dba Affinity Hospice

  • Community Based Hospice Care Agency
  • Claxton, GA
  • NPI 1548501000

  Family Medicine

  Medicare reassignment NPD
• Bethany Hospice and Palliative Care, LLC

  • Community Based Hospice Care Agency
  • Valdosta, GA
  • NPI 1972709160

  Family Medicine

  Medicare reassignment NPD
• Coffee County Hospitalist Physicians, LLC

  • Independent Medical Examiner Physician
  • Douglas, GA
  • NPI 1811435464
  Medicare reassignment NPD
• Coffee Emergency Group LLC

  • Emergency Medicine Physician
  • Douglas, GA
  • NPI 1023353489
  Medicare reassignment NPD
• Coffee Regional Medical Center, Inc

  dba Coffee Regional First Care

  • Rural Health Clinic/Center
  • Douglas, GA
  • NPI 1639211956
  NPD
• CRH Physician Practices LLC

  dba CRH Medical Group

  • Internal Medicine Physician
  • Hazlehurst, GA
  • NPI 1720348899
  NPD
• Tift Regional Health System Inc

  dba Tift Regional Ophthalmology

  • Ophthalmology Physician
  • Tifton, GA
  • NPI 1790280857
  NPD
• 24 On Physicians, P.C.

  • Hospitalist Physician
  • Attleboro, MA
  • NPI 1790104511
  NPD
• D. Conrad Harper, MD LLC

  • Internal Medicine Physician
  • Douglas, GA
  • NPI 1326245382
  NPD (past)

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

• Amedisys Georgia, L.L.C.

  dba Amedisys Home Health

  • Home Health Agency
  • Waycross, GA
  • NPI 1316120322
  Care Compare affiliation
• Centerwell Health Services USA LLC

  dba CenterWell Home Health

  • Home Health Agency
  • Homerville, GA
  • NPI 1558343145
  Care Compare affiliation
• Coffee Regional Medical Center, Inc

  dba Coffee Regional Medical Center

  • General Acute Care Hospital
  • Douglas, GA
  • NPI 1760419527
  Care Compare affiliation

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1285756163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DRIVE",
            "address_2": "SUITE 106",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332203",
            "telephone_number": "912-384-3338",
            "fax_number": "912-384-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DRIVE",
            "address_2": "SUITE 106",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332203",
            "telephone_number": "912-384-3338",
            "fax_number": "912-384-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "JUSTIN",
        "middle_name": "FLYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "59162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870694111C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "059162",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Leigh Harden-Lee, BCBA
• Hark Pharmaceutical, LLC (Malcolms Discount Pharmacy)
• Dean M Harper, PA-C
• Dennis Conrad Harper, M.D.
• Nash Dawson Harper, FNP-C
• Shirley Lavon Harrell, NP
• Kelsie Harris
• Hazlehurst Family Clinic LLC
• Hear Again Inc (Audibel Hearing Aid Centers)
• Helping Hands Homecare Agency LLC

• Family Medicine Physician in Douglas, GA
• Providers in Douglas, 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 May 20, 2014; 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.