Individual provider Active NPI

David Daniel Brosnahan, M.D., M.S.

  • Emergency Medicine Physician
  • Evans, GA
National Provider Identifier
1457474363
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
059132 Issued in GA
Practice address
512 Thompkins LN
Evans, GA 30809-4304
Phone
(706) 814-0679
NPI assigned
Apr 6, 2007
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 RTP001199 GA
Emergency Medicine Physician 207P00000X 059132 GA Primary

Addresses

Primary practice location

512 Thompkins LN
Evans, GA 30809-4304

Mailing address

512 Thompkins LN
Evans, GA 30809-4304
Phone (706) 814-0679

Other practice location 1

3651 Wheeler Rd
Augusta, GA 30909-6426
Phone (706) 651-6080

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
I20080112000108 GA Practitioner - Emergency Medicine 7012098338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.67 of 100Reported as group
Improvement activities
40
Cost
79.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RTP001199GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jul 31, 2019 Accepting new patients
Peach State Emergency Physicians LLC Emergency Medicine CurrentSince May 1, 2024 Accepting new patients

Locations

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

2460 Washington Rd
Thomson, GA 30824
Phone (706) 595-1411

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, 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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1457474363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 THOMPKINS LN",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094304",
            "telephone_number": "706-814-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 THOMPKINS LN",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094304",
            "telephone_number": "706-814-0679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3651 Wheeler Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096426",
            "country_code": "US",
            "telephone_number": "706-651-6080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROSNAHAN",
        "first_name": "DAVID",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "RTP001199",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "059132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.