NPIMap

Individual provider Active NPI

John Brachey, MD

  • Internal Medicine Physician
  • Fayetteville, GA
National Provider Identifier
1558459768
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
052894 Issued in GA
Practice address
1330 Highway 74
Fayetteville, GA 30215-2950
Phone
(770) 631-2502
Fax
(770) 631-2503
NPI assigned
Oct 11, 2006
Last updated
Aug 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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 052894 GA
Internal Medicine Physician 207R00000X 052894 GA Primary

Addresses

Primary practice location

1330 Highway 74
Fayetteville, GA 30215-2950

Mailing address

1330 Highway 74
Fayetteville, GA 30215-2950
Phone (770) 631-2502

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
I20040510001254 GA Practitioner - Emergency MedicinePractitioner - Internal Medicine 3173512688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
Medical College of Georgia School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Starr's Mill Internal Medicine, LLCGroup PAC ID 1658328661, 2 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1330 Hwy 74
Fayetteville, GA 30215-2950
Phone (770) 631-2502

9152 Hwy 278 NE
Covington, GA 30014-7010
Phone (678) 342-9339

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
052894GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Starr's Mill Internal Medicine, LLC Internal Medicine CurrentSince Apr 1, 2005 Accepting new patients
Peachtree Emergency Associates Emergency Medicine Past Accepting new patients
Floyd Memorial Hospital and Health Services Past Accepting new patients
Peachtree Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

1330 Highway 74
Fayetteville, GA 30215
Phone (770) 631-2502

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1558459768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 HIGHWAY 74",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152950",
            "telephone_number": "770-631-2502",
            "fax_number": "770-631-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 HIGHWAY 74",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302152950",
            "telephone_number": "770-631-2502",
            "fax_number": "770-631-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACHEY",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "052894",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "052894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.