Individual provider Active NPI

Evan Monson, MD

  • Obstetrics & Gynecology Physician
  • Conyers, GA
National Provider Identifier
1427553577
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
93322 Issued in GA
Practice address
3240 Avalon Blvd
Conyers, GA 30013-6320
Phone
(770) 860-1133
Fax
(770) 860-1599
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 93322 GA Primary

Addresses

Primary practice location

3240 Avalon Blvd
Conyers, GA 30013-6320

Mailing address

3240 Avalon Blvd
Conyers, GA 30013-6320
Phone (770) 860-1133

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
I20221111000460 GA Practitioner - Obstetrics/Gynecology 1850648510 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93322GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greystone OBGYN PC CurrentSince Dec 1, 2022 Accepting new patients
Piedmont Rockdale Hospital Inc. Past Accepting new patients

Locations

3240 Avalon Blvd
Conyers, GA 30013
Phone (770) 860-1133

4134 Highway 278 NE
Covington, GA 30014
Phone (770) 788-7447

Interoperability endpoints

  • Direct secure messaging: evan@greystoneobgyn.gwaydirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1427553577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 AVALON BLVD",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136320",
            "telephone_number": "770-860-1133",
            "fax_number": "770-860-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 AVALON BLVD",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136320",
            "telephone_number": "770-860-1133",
            "fax_number": "770-860-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONSON",
        "first_name": "EVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "93322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.