NPIMap

Individual provider Active NPI

Dale Mitchell Bearman, M.D.

  • Gynecology Physician
  • Marietta, GA
National Provider Identifier
1457348377
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
030432 Issued in GA
Practice address
4800 Olde Towne Pkwy
Suite 150
Marietta, GA 30068-4357
Phone
(770) 977-1510
Fax
(770) 509-8858
NPI assigned
Oct 5, 2005
Last updated
Mar 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 030432 GA Primary

Addresses

Primary practice location

4800 Olde Towne Pkwy
Suite 150
Marietta, GA 30068-4357

Mailing address

5780 Peachtree Dunwoody Road
Suite 300
Atlanta, GA 30342-1513
Phone (404) 303-1224

Other identifiers 3

IdentifierTypeStateIssuer
000478838DMedicaidGA
000478838IMedicaidGA
000478838HMedicaidGA

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
I20110513000692 GA Practitioner - Obstetrics/Gynecology 9830270610

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Women's Health Group, P.C. Current Accepting new patients
Northside Surgical Professional Services LLC PastSince Apr 1, 2013 Accepting new patients
NSH Cancer Institute Professional Services G LLC PastSince Jan 1, 2013 Accepting new patients
NSH Cancer Institute Professional Services a LLC PastSince Jan 1, 2013 Accepting new patients

Locations

5780 Peachtree Dunwoody Rd
Ste 295
Sandy Springs, GA 30342
Phone (404) 255-0621

5780 Peachtree Dunwoody Rd
Ste 300
Sandy Springs, GA 30342
Phone (404) 252-1137

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northside Hospital ForsythCumming, GA, CCN 110005 Hospital Corporate Director Nov 19, 2007
Northside Hospital AtlantaAtlanta, GA, CCN 110161 Hospital Corporate Director Nov 19, 2007
Northside Hospital CherokeeCanton, GA, CCN 110008 Hospital Corporate Director Feb 1, 2007
Northside Hospital GwinnettLawrenceville, GA, CCN 110087 Hospital Corporate Director Feb 1, 2007
Northside Hospital DuluthDuluth, GA, CCN 110252 Hospital Corporate Director Feb 1, 2007
Northside Hospital IncDuluth, GA, CCN 11T252 Hospital Corporate Director Feb 1, 2007

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1457348377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5780 PEACHTREE DUNWOODY ROAD",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421513",
            "telephone_number": "404-303-1224",
            "fax_number": "404-303-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 OLDE TOWNE PKWY",
            "address_2": "SUITE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684357",
            "telephone_number": "770-977-1510",
            "fax_number": "770-509-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARMAN",
        "first_name": "DALE",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "030432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000478838D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000478838I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000478838H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.