NPIMap

Individual provider Active NPI

Ethan McBrayer, DO

  • Family Medicine Physician
  • Moultrie, GA
National Provider Identifier
1821652843
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
87094 Issued in GA
Practice address
6 Hospital Park
Moultrie, GA 31768-6700
Phone
(229) 985-3320
Fax
(229) 890-1282
NPI assigned
Apr 24, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 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 87094 GA Primary

Addresses

Primary practice location

6 Hospital Park
Moultrie, GA 31768-6700

Mailing address

PO Box 2876
Moultrie, GA 31776-2876
Phone (229) 985-3320

Other practice location 1

3131 S Main St
Moultrie, GA 31768-6925
Phone (229) 502-9769

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
I20220724000071 GA Practitioner - Family Practice 9335520204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia Col of Osteo Med, Sewanee, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colquitt Regional Hospitalists, LLC 28 clinicians
Colquitt Regional Medical Center 20 clinicians

Practice addresses (Care Compare)

3131 S Main St
Moultrie, GA 31768-6925
Phone (229) 502-9782

6 Hospital Park
Moultrie, GA 31768-6700
Phone (229) 985-3320

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Tifton, GA, CCN 117077
  • Colquitt Regional Medical Center Hospital, Moultrie, GA, CCN 110105

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Colquitt Regional Pathology, LLC Current Accepting new patients
Colquitt Regional Medical Center Family Medicine Current Accepting new patients
Colquitt Regional Medical Center CurrentSince Jul 1, 2022 Accepting new patients
Colquitt Regional Hospitalists, LLC CurrentSince Dec 13, 2022 Accepting new patients
Colquitt Regional Medical Center CurrentSince Jul 1, 2022 Accepting new patients
Colquitt Regional Medical Center Family Medicine Current Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

6 Hospital Park
Moultrie, GA 31768
Phone (229) 891-9009

1 Magnolia Ct
Moultrie, GA 31768
Phone (229) 502-9753

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1821652843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2876",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317762876",
            "telephone_number": "229-985-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HOSPITAL PARK",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686700",
            "telephone_number": "229-985-3320",
            "fax_number": "229-890-1282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3131 S Main St",
            "address_purpose": "LOCATION",
            "city": "Moultrie",
            "state": "GA",
            "postal_code": "317686925",
            "country_code": "US",
            "telephone_number": "229-502-9769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCBRAYER",
        "first_name": "ETHAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-24",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "87094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

Verify at the official NPI Registry.