NPIMap

Individual provider Active NPI

Nathan H Brandon, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Evans, GA
National Provider Identifier
1528060803
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
039536 Issued in GA
Practice address
621 Ponder Place Dr
Suite 2
Evans, GA 30809-3194
Phone
(706) 364-2980
Fax
(706) 364-2982
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 039536 GA Primary

Addresses

Primary practice location

621 Ponder Place Dr
Suite 2
Evans, GA 30809-3194

Mailing address

621 Ponder Place Dr
Suite 2
Evans, GA 30809-3194
Phone (706) 364-2980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Walton Rehabiltation Hospital Past Accepting new patients
Carolina Musculoskeletal Institute PA Pain Medicine PastSince Jul 13, 1995 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8321/brand/1/csg/1/fhir/r4

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1528060803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 PONDER PLACE DR",
            "address_2": "SUITE 2",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093194",
            "telephone_number": "706-364-2980",
            "fax_number": "706-364-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 PONDER PLACE DR",
            "address_2": "SUITE 2",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093194",
            "telephone_number": "706-364-2980",
            "fax_number": "706-364-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON",
        "first_name": "NATHAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "039536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.