Michael Daren Mudrey, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

38564 Issued in GA

Practice address

3540 Cobb Pkwy
Ste 100
Acworth, GA 30101

Phone

(706) 632-3711

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Nova Southeastern College of Osteo Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fort Oglethorpe Emergency Physicians Group LLCGroup PAC ID 8527323633, 5 clinicians

Southland Union Emergency Medical Services, LLCGroup PAC ID 8224308770, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blue Ridge Medical Center Hospital, Blue Ridge, GA, CCN 111338
• Union General Hospital Hospital, Blairsville, GA, CCN 110051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmudrey@yourcarecommunity.org

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.

• Fort Oglethorpe Emergency Physicians Group LLC

  • Emergency Medicine Physician
  • Blue Ridge, GA
  • NPI 1174024376

  Emergency Medicine, GA

  Medicare reassignment Care Compare group NPD
• Southland Union Emergency Medical Services, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Blairsville, GA
  • NPI 1164954715

  GA

  Medicare reassignment Care Compare group NPD
• Hartwell Emergency Physicians LLC

  • Emergency Medicine Physician
  • Hartwell, GA
  • NPI 1962540849

  Emergency Medicine, GA

  Medicare reassignment NPD
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156

  GA

  Medicare reassignment NPD
• Southland Chatuge Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Hiawassee, GA
  • NPI 1881127942

  Emergency Medicine, GA

  Medicare reassignment NPD
• Southland Emergency Medical Services Consolidated, LLC

  • Hospitalist Physician
  • Cochran, GA
  • NPI 1033464391

  GA

  Medicare reassignment
• Hartwell Emergency Physicians LLC

  • Emergency Medicine Physician
  • Lavonia, GA
  • NPI 1467710152

  Emergency Medicine

  NPD
• Hospitalmd of Georgia, Inc.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Ellijay, GA
  • NPI 1861762064
  NPD (past)
• Inphynet Primary Care Physicians Southeast PC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1770521460

  Emergency Medicine

  NPD (past)
• North Georgia Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Ellijay, GA
  • NPI 1336172923

  Emergency Medicine

  NPD (past)
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  Emergency Medicine

  NPD (past)
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  NPD (past)

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

• Blue Ridge Georgia Hospital Company LLC

  • Critical Access Hospital
  • Blue Ridge, GA
  • NPI 1851362263

  Hospital

  Care Compare affiliation
• Union County Hospital Authority

  • General Acute Care Hospital
  • Blairsville, GA
  • NPI 1487684122

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1376574863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1332",
            "city": "MC CAYSVILLE",
            "state": "GA",
            "postal_code": "305551332",
            "telephone_number": "706-632-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 COBB PKWY",
            "address_2": "STE 100",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "30101",
            "telephone_number": "706-632-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDREY",
        "first_name": "MICHAEL",
        "middle_name": "DAREN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "038564",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "38564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000621398J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Acworth, GA
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.