Individual provider Active NPI

Mary Ellen Middleton Fain, MD

  • Pediatric Pulmonology Physician
  • Atlanta, GA
National Provider Identifier
1336775378
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
96262 Issued in GA
Practice address
49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049
Phone
(706) 414-2428
NPI assigned
Mar 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 96262 GA Primary

Addresses

Primary practice location

49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049

Mailing address

3101 Bransford Rd
Augusta, GA 30909-3007
Phone (706) 414-2428

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200819001188 GA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7012333230

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1336775378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BRANSFORD RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093007",
            "telephone_number": "706-414-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033049",
            "telephone_number": "706-414-2428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIN",
        "first_name": "MARY ELLEN",
        "middle_name": "MIDDLETON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-22",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "GA",
            "license": "96262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.