Individual provider Active NPI

Brejon Michael Childers, MD

  • Family Medicine Physician
  • Dunwoody, GA
National Provider Identifier
1669175980
Registry record updated Sep 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
104838 Issued in GA
Practice address
4500 N Shallowford Rd Ste B
Dunwoody, GA 30338-6476
Phone
(404) 778-6920
Fax
(404) 778-6901
NPI assigned
Mar 24, 2023
Last updated
Sep 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 104838 GA Primary

Addresses

Primary practice location

4500 N Shallowford Rd Ste B
Dunwoody, GA 30338-6476

Mailing address

4500 N Shallowford Rd Ste B
Dunwoody, GA 30338-6476
Phone (404) 778-6920

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
I20251031000972 GA Practitioner - Family Practice 9335500925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Morehouse School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104838GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Oct 21, 2025 Accepting new patients

Locations

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

Organizations & group practices 1

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": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758412800000",
    "number": "1669175980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 N SHALLOWFORD RD STE B",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303386476",
            "telephone_number": "404-778-6920",
            "fax_number": "404-778-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 N SHALLOWFORD RD STE B",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303386476",
            "telephone_number": "404-778-6920",
            "fax_number": "404-778-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "BREJON",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-24",
        "last_updated": "2025-09-21",
        "certification_date": "2025-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "104838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

Verify at the official NPI Registry.