Individual provider Active NPI

Earl Alwin Grubbs, MD

  • Emergency Medicine Physician
  • Johns Creek, GA
National Provider Identifier
1902863004
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
032742 Issued in GA
Practice address
375 High Bridge Chase
Johns Creek, GA 30022-5512
Phone
(770) 740-9231
Fax
(770) 569-4598
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 032742 GA Primary

Addresses

Primary practice location

375 High Bridge Chase
Johns Creek, GA 30022-5512

Mailing address

375 High Bridge Chase
Johns Creek, GA 30022-5512
Phone (770) 740-9231

Other identifiers 1

IdentifierTypeStateIssuer
000471589BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032742GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gwinnett Emergency Specialists Observation Services, LLC Emergency Medicine CurrentSince Aug 1, 2012 Accepting new patients
Gwinnett Emergency Specialists, LLC Emergency Medicine CurrentSince Aug 1, 2012 Accepting new patients
Northside Emergency Associates, LLC Emergency Medicine CurrentSince Mar 20, 2020 Accepting new patients
Paragon Emergency Physicians PC Emergency Medicine PastSince Feb 1, 1996 Accepting new patients

Locations

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Organizations & group practices 4

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1902863004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 HIGH BRIDGE CHASE",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300225512",
            "telephone_number": "770-740-9231",
            "fax_number": "770-569-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 HIGH BRIDGE CHASE",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300225512",
            "telephone_number": "770-740-9231",
            "fax_number": "770-569-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBBS",
        "first_name": "EARL",
        "middle_name": "ALWIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "032742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000471589B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.