NPIMap

Individual provider Active NPI

Ethan Rogers, MD

  • Emergency Medicine Physician
  • Gainesville, GA
National Provider Identifier
1639220239
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
059926 Issued in GA
Practice address
743 Spring St
Gainesville, GA 30501
Phone
(678) 862-1796
Fax
(770) 533-8949
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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 ME99797 FL
Emergency Medicine Physician 207P00000X 059926 GA Primary

Addresses

Primary practice location

743 Spring St
Gainesville, GA 30501

Mailing address

743 Spring St
Gainesville, GA 30501
Phone (678) 862-1796

Other identifiers 2

IdentifierTypeStateIssuer
429866120CMedicaidGA
GRP4155OtherGAMEDICARE GROUP NUMBER

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
I20080107000434 GA Practitioner - Emergency Medicine 0840388526 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Georgia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Emergency Department Services, P.C. 76 clinicians

Practice addresses (Care Compare)

1400 River PL
Braselton, GA 30517-5600
Phone (770) 219-9000

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 503-3000

Hospital & facility affiliations

  • Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237
  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041
  • Morgan Medical Center Hospital, Madison, GA, CCN 111304
  • NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045

Merit-based Incentive Payment System (MIPS)

Final score
92.02 of 100Reported as group
Quality
91.38
Improvement activities
40
Cost
79.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME99797FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morgan County Georgia Hospital Authority Current Accepting new patients
Union County Hospital Authority CurrentSince Feb 24, 2015 Accepting new patients
Union County Hospital Authority CurrentSince Feb 24, 2015 Accepting new patients
Georgia Emergency Department Services, P.C. Emergency Medicine CurrentSince Aug 1, 2008 Accepting new patients
Emergency Medicine South LLC Emergency Medicine Past Accepting new patients
Darling Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Wendy L Smith M.D. PC Past Accepting new patients
Lavender Inpatient Services LLC Past Accepting new patients
Solantic LLC Past Accepting new patients

Locations

35 Hospital Rd
Blairsville, GA 30512
Phone (706) 439-6812

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

Interoperability endpoints

  • Direct secure messaging: ethanrogers@mmc.medalliesdirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1639220239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 SPRING ST",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "678-862-1796",
            "fax_number": "770-533-8949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "678-862-1796",
            "fax_number": "770-533-8949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "ETHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME99797",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "059926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429866120C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "GRP4155",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.