Bryan Watkins Whitfield VI, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

87251 Issued in GA

Practice address

980 Sanders Rd Ste 100
Cumming, GA 30041-5977

Phone

(770) 886-1074

Fax

(770) 205-4717

NPI assigned

Aug 27, 2013

Last updated

Dec 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

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

General Surgery

Education

Mercer University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD

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

• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1841624731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 SANDERS RD STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415977",
            "telephone_number": "770-886-1074",
            "fax_number": "770-205-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 SANDERS RD STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415977",
            "telephone_number": "770-886-1074",
            "fax_number": "770-205-4717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Wood St",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033040",
            "country_code": "US",
            "telephone_number": "706-974-7778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "706-974-7778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITFIELD",
        "first_name": "BRYAN",
        "middle_name": "WATKINS",
        "name_suffix": "VI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-27",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "29636",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL37087",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "87251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BOARD OF MEDICINE",
            "identifier": "29636",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF SOUTH CAROLINA LIMITED LICENSE",
            "identifier": "LL37087",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher John White
• Mara Felice White, BCBA
• Stephen Franklin White Jr., MD
• Deborah E Whitehair, PA
• James Richard Whitehead, PHARMD
• Kyanda Whitley
• David James Whitney, DDS
• Jancie Lynn Wieting, PHARM.D.
• Mark S Wiggers, OD
• Dennis Wiles, MD

• Surgery Physician in Cumming, GA
• Providers in Cumming, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.