Individual provider Active NPI

Natalie Ronnette Brathwaite, M.D.

  • Obstetrics & Gynecology Physician
  • Douglasville, GA
National Provider Identifier
1811964109
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
50345 Issued in GA
Practice address
6095 Professional Pkwy Ste A210
Douglasville, GA 30134-5611
Phone
(770) 949-4188
NPI assigned
Mar 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 19777 MS
Obstetrics & Gynecology Physician 207V00000X 50345 GA Primary

Addresses

Primary practice location

6095 Professional Pkwy Ste A210
Douglasville, GA 30134-5611

Mailing address

6095 Professional Pkwy Ste A210
Douglasville, GA 30134-5611
Phone (770) 949-4188

Other practice location 1

1900 Grandview Dr
Grenada, MS 38901-5066
Phone (662) 226-5121

Other identifiers 1

IdentifierTypeStateIssuer
0110577MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nbrathwaite131927@directwellstar.org

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
I20161215000261 GA Practitioner - Obstetrics/Gynecology 3678665064

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50345GAMDObstetrics & Gynecology Physician
19777MSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Grenada Clinic for Women, PA Obstetrics & Gynecology Past Accepting new patients

Locations

6095 Professional Pkwy
Ste A210
Douglasville, GA 30134
Phone (770) 949-4188

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

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": "1141516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1811964109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6095 PROFESSIONAL PKWY STE A210",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345611",
            "telephone_number": "770-949-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6095 PROFESSIONAL PKWY STE A210",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345611",
            "telephone_number": "770-949-4188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Grandview Dr",
            "address_purpose": "LOCATION",
            "city": "Grenada",
            "state": "MS",
            "postal_code": "389015066",
            "country_code": "US",
            "telephone_number": "662-226-5121",
            "fax_number": "662-226-7529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRATHWAITE",
        "first_name": "NATALIE",
        "middle_name": "RONNETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-05",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "19777",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "50345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110577",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbrathwaite131927@directwellstar.org",
            "affiliation": "N",
            "address_1": "6095 Professional Pkwy Ste A210",
            "city": "Douglasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301345611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.