Charles Miller Brown Sr., M.D.
Individual provider Active NPI Diagnostic Radiology Physician · Bainbridge, GA
NPI 1437417359 · NPPES record last updated Jun 28, 2024
Key facts
- NPI
- 1437417359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 77094 (GA)
- Practice address
- 1500 E Shotwell St
Bainbridge, GA 39819-4256 - Phone
- (229) 425-4903
- NPI assigned
- Apr 28, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Mercer University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sterling Radiology LLC
South Georgia Radiology Associates LLC
Practice addresses (Care Compare)
3131 S Main St
Moultrie, GA 31768-6925
Phone (229) 890-3500
340 Eisenhower Dr
Suite 1305
Savannah, GA 31406-1607
Phone (888) 545-5551
Hospital & facility affiliations
- Union General Hospital
- Memorial Hospital and Manor
- Tift Regional Medical Center
- Wayne Memorial Hospital
- Northeast Georgia Medical Center Habersham
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171205003377 | GA | Practitioner - Diagnostic Radiology |
1153688858 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77094 | GA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Behavioral Health and Developmental Disabilities | Current | Accepting new patients | |
| Privia Medical Group of Georgia LLC | Current |
Accepting new patients | |
| Department of Behavioral Health & Developmental Disabilities, Ga | Current |
Accepting new patients | |
| Bca Georgia, LLC | Current |
Accepting new patients | |
| Privia Medical Group of Georgia LLC | Current |
Accepting new patients | |
| Department of Behavioral Health & Developmental Disabilities | Current |
Accepting new patients | |
| Sterling Radiology LLC | Current |
Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients | |
| South Georgia ER Services, LLC | Past | Accepting new patients |
Locations
3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030
101 Lake Oconee Pkwy
Eatonton, GA 31024
Phone (706) 485-0907
101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285
101 Hartford Rd W
Ste 1
Fort Gaines, GA 39851
Phone (229) 210-2100
138 N College St
Hamilton, GA 31811
Phone (478) 776-4000
11 Main St
Unit 201
Jekyll Island, GA 31527
Phone (912) 766-0755
250 Mlk Blvd
Macon, GA 31201
Phone (478) 301-2362
1850 N Columbia St
Ste 3
Milledgeville, GA 31061
Phone (478) 453-4101
3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769
1915 Eisenhower Dr
Savannah, GA 31406
Phone (912) 356-2011
801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD2019-0133 | NM | |
| Diagnostic Radiology Physician | 2085R0202X | 77094 | GA | Yes |
Addresses
Primary practice location
1500 E Shotwell St
Bainbridge, GA 39819-4256
Mailing address
7505 Waters Ave Ste F10
Savannah, GA 31406-3822
Phone (229) 425-4903
Other providers in Bainbridge, GA
- Katherine Szakal Bridges
- Marcia Willis Brock
- Marty Dewayne Brock
- Winston B Brock
- Marianna Brooks
- Gloria Browne
- Lawante Laniece Bryant-Scott
- Matthew Buck
- Burke & Robinson MD PC
- Kenneth Dean Burke
All providers in Bainbridge, GA · Diagnostic Radiology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.