Brandon Penn, M.D., M.B.A.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

073784 Issued in GA

Practice address

531 Asbury Cir
Suite N340
Atlanta, GA 30322-1006

Phone

(404) 778-5975

NPI assigned

Apr 10, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Emergency Medicine

Education

Columbia University College of Physicians and Surgeons, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Emergency Associates, P.C.Group PAC ID 9335135144, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Northside Emergency Associates, LLC

  • Emergency Medicine Physician
  • Sandy Springs, GA
  • NPI 1285686303

  Emergency Medicine, GA

  Medicare reassignment Care Compare group NPD
• The Bortolazzo Group, LLC

  • Emergency Medicine Physician
  • Austell, GA
  • NPI 1801965082

  Emergency Medicine, GA

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396

  Hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1831455294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 ASBURY CIR",
            "address_2": "SUITE N340",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 ASBURY CIR",
            "address_2": "SUITE N340",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221006",
            "telephone_number": "404-778-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "BRANDON",
        "credential": "M.D., M.B.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "073784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Pendley
• Stephanie Pendley, CPNP
• Dana Gabrielle Penfold
• Alainey Penn, PT
• Andrea Nicole Penn, NP
• Pamela Penn, LPC
• Selena Marie Penn, RN
• Deonna Rakel Pennamon, LAT, ATC
• Leslie Jones Pennington
• Scott D Pennington, MD

• All providers in Atlanta, GA
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.