Individual provider Active NPI

Bobby Cecil Gearing III, MD, MS

  • Pediatrics Physician
  • Griffin, GA
National Provider Identifier
1669752846
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
263126 Issued in NY
Practice address
1900 Zebulon Rd
Griffin, GA 30224-5117
Phone
(770) 227-5510
NPI assigned
Aug 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 86130 GA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 263126 NY Primary

Addresses

Primary practice location

1900 Zebulon Rd
Griffin, GA 30224-5117

Mailing address

1900 Zebulon Rd
Griffin, GA 30224-5117
Phone (770) 227-5510

Other practice location 1

94 E Oakland Ave Ste A
Camilla, GA 31730-1529
Phone (229) 336-9769

Other practice location 2

104 Fulton Ave
Poughkeepsie, NY 12603-2808
Phone (845) 452-1700

Other identifiers 1

IdentifierTypeStateIssuer
003245194MedicaidGA

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
I20260624000317 GA Practitioner - Pediatric Medicine 3678046497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr SE
Box 26019
Atlanta, GA 30303-3031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
263126NYMDPediatrics Physician
86130GAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mitchell County Pediatrics and Health Center CurrentSince Jun 1, 2023 Accepting new patients
Griffin Pediatrics PA Pediatrics PastSince Jun 1, 2023 Accepting new patients

Locations

94 E Oakland Ave
Ste A
Camilla, GA 31730
Phone (229) 336-9769

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCBGDD/Endpoint/HCBGDD

Organizations & group practices 3

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": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1669752846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 ZEBULON RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302245117",
            "telephone_number": "770-227-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ZEBULON RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302245117",
            "telephone_number": "770-227-5510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 E Oakland Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Camilla",
            "state": "GA",
            "postal_code": "317301529",
            "country_code": "US",
            "telephone_number": "229-336-9769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Fulton Ave",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126032808",
            "country_code": "US",
            "telephone_number": "845-452-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEARING",
        "first_name": "BOBBY",
        "middle_name": "CECIL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-19",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "86130",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "263126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003245194",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.