NPIMap

Individual provider Active NPI

Michael Jacob Mulberry, MD

  • Family Medicine Physician
  • Dahlonega, GA
National Provider Identifier
1386696268
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
050725 Issued in GA
Practice address
23 Tipton Dr
Dahlonega, GA 30533-1603
Phone
(706) 867-6505
Fax
(706) 867-6505
NPI assigned
May 17, 2006
Last updated
Aug 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 50725 GA
Family Medicine Physician 207Q00000X 050725 GA Primary

Addresses

Primary practice location

23 Tipton Dr
Dahlonega, GA 30533-1603

Mailing address

PO Box 658
Gainesville, GA 30503-0658
Phone (770) 718-1122

Other practice location 1

101 Lake Oconee Pkwy
Eatonton, GA 31024-8512
Phone (706) 485-2711

Other identifiers 2

IdentifierTypeStateIssuer
P00318980OtherGARAILROAD MEDICARE
000938803EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109000290 GA Practitioner - Family PracticePractitioner - Emergency Medicine 4981627635 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Medical College of Georgia School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reid Emergency Group, PCGroup PAC ID 5991051872, 11 clinicians
The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians
Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

101 Lake Oconee Pkwy
Eatonton, GA 31024-8512
Phone (706) 485-2711

23 Tipton Dr
Dahlonega, GA 30533-1603
Phone (706) 867-6505

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (770) 297-5700

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 219-9000

801 Austin Dr
Demorest, GA 30535-4513
Phone (770) 536-2323

835 Austin Dr
Demorest, GA 30535-4513
Phone (706) 754-8066

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.1 of 100Reported as group
Quality
87.6
Promoting interoperability
100
Improvement activities
40
Cost
76.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50725GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Longstreet Clinic PC CurrentSince May 11, 2012 Accepting new patients
The Longstreet Clinic, PC Family Medicine CurrentSince May 11, 2012 Accepting new patients
Chatuge Regional Hospital Inc CurrentSince Aug 13, 2015 Accepting new patients
Reid Emergency Group, PC Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients
Northeast Georgia Community Physicians LLC CurrentSince Feb 1, 2026 Accepting new patients
Chatuge Regional Hospital Inc CurrentSince Aug 13, 2015 Accepting new patients
Chatuge Regional Hospital Inc Past Accepting new patients
United Emergency Services, Inc. Emergency Medicine Past Accepting new patients
Georgia Heart Institute LLC PastSince Jan 8, 2018 Accepting new patients
Southern Health Corporation of Dahlonega, Inc Family Medicine Past Accepting new patients
South Carolina Em-I Medical Services PC Emergency Medicine Past Accepting new patients

Locations

227 Mountain Dr
Dahlonega, GA 30533
Phone (706) 864-6136

23 Tipton Dr
Dahlonega, GA 30533
Phone (706) 864-0334

24 Alicia Ln
Ste 7
Dahlonega, GA 30533
Phone (706) 391-6555

101 Lake Oconee Pkwy
Eatonton, GA 31024
Phone (706) 485-0907

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 297-2200

110 S Main St
Hiawassee, GA 30546
Phone (706) 896-2222

1155 Main St
Young Harris, GA 30582
Phone (706) 439-6873

Interoperability endpoints

  • Direct secure messaging: michael.mulberry@longstreetclinic.gadirect.net

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1386696268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-533-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 TIPTON DR",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305331603",
            "telephone_number": "706-867-6505",
            "fax_number": "706-867-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Lake Oconee Pkwy",
            "address_purpose": "LOCATION",
            "city": "Eatonton",
            "state": "GA",
            "postal_code": "310248512",
            "country_code": "US",
            "telephone_number": "706-485-2711",
            "fax_number": "706-485-6770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULBERRY",
        "first_name": "MICHAEL",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "50725",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "050725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00318980",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000938803E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dahlonega, GA

Sources for this page

Verify at the official NPI Registry.