Individual provider Active NPI

Brandon M Earehart, PAC

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1881701472
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6113 Issued in GA
Practice address
9100 White Bluff Rd Ste 501
Savannah, GA 31406-4672
Phone
(912) 800-1017
Fax
(877) 836-3638
NPI assigned
Aug 23, 2006
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00081700 NJ
Physician Assistant 363A00000X 6113 GA Primary

Addresses

Primary practice location

9100 White Bluff Rd Ste 501
Savannah, GA 31406-4672

Mailing address

9100 White Bluff Rd Ste 501
Savannah, GA 31406-4672
Phone (912) 800-1017

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110629000746 GA Practitioner - Physician Assistant 3072706167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Starland Family PracticeGroup PAC ID 2264868959, 2 clinicians

Practice addresses (Care Compare)

9100 White Bluff Rd
Suite 501
Savannah, GA 31406-4672
Phone (912) 800-1017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6113GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pediatric Specialists LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: earehart@sfp-ga.direct.office.nextgen.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1881701472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 WHITE BLUFF RD STE 501",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064672",
            "telephone_number": "912-800-1017",
            "fax_number": "877-836-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 WHITE BLUFF RD STE 501",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064672",
            "telephone_number": "912-800-1017",
            "fax_number": "877-836-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAREHART",
        "first_name": "BRANDON",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00081700",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.