Individual provider Active NPI

John C Earle, M.D.

  • Adult Medicine Physician
  • Carrollton, GA
National Provider Identifier
1376625087
Registry record updated Jun 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
032723 Issued in GA
Practice address
251 Croft St
Carrollton, GA 30117-3863
Phone
(770) 834-7117
NPI assigned
Oct 20, 2006
Last updated
Jun 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 032723 GA Primary

Addresses

Primary practice location

251 Croft St
Carrollton, GA 30117-3863

Mailing address

251 Croft St
Carrollton, GA 30117-3863
Phone (770) 834-7117

Other identifiers 1

IdentifierTypeStateIssuer
00436488AMedicaidGA

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
I20101103000766 GA Practitioner - Family Practice 7416141460 Practice locations: Carrollton, GA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

251 Croft St
Carrollton, GA 30117-3863
Phone (770) 834-7117

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032723GAMDAdult Medicine Physician

Hospital & facility affiliations 2

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435363200000",
    "number": "1376625087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 CROFT ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173863",
            "telephone_number": "770-834-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 CROFT ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173863",
            "telephone_number": "770-834-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLE",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2015-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "GA",
            "license": "032723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00436488A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.