NPIMap

Organization Active NPI

Lifebrite Hospital Group of Early LLC

  • Rural Health Clinic/Center
  • Blakely, GA
National Provider Identifier
1912430224
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LIFEBRITE HOSPITAL GROUP OF EARLY LLC
Practice address
11045 Columbia St
Suite B
Blakely, GA 39823-3447
Phone
(229) 723-4313
NPI assigned
Apr 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Authorized official

Name
Morgan Dunn
Title
Ceo
Phone
(601) 849-6440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

11045 Columbia St
Suite B
Blakely, GA 39823-3447

Mailing address

11045 Columbia St
Suite B
Blakely, GA 39823-3447

Other names 1

  • LifeBrite Family Medical of Early Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171024003011 GA Part B Supplier - Clinic/Group Practice 7810263589 Receives reassigned benefits from 30 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Blakely, GA
O20181206003421 GA Part A Provider - Rural Health Clinic 7810263589 Practice locations: Blakely, GA

Rural health clinic certification: CCN 118509

Legal name
LIFEBRITE HOSPITAL GROUP OF EARLY LLC
Doing business as
LIFEBRITE FAMILY MEDICAL OF EARLY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 15, 2005
Last certification
Jan 13, 2026
Ownership / control type
1B
Most recent change of ownership
Nov 1, 2017 (2 total)
Organization structure
LLCProprietary
Incorporated
Mar 27, 2017 in GA
Enrollment address
11045 Columbia St
Blakely, GA 39823-3447
Related CCNs
111314

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0265994Lifebrite Family Medical of Early11045 Columbia Street, Blakely, GA 39823Certificate of waiverMar 31, 2028

National Provider Directory

National Provider Directory

Locations

11045 Columbia St
Ste B
Blakely, GA 39823
Phone (229) 723-4313

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Echp, Inc. Organization, Magee, MS Corporation, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2023 100%
Morgan Dunn Individual Corporate DirectorManging Member Feb 1, 2023
Ginger Cushing Individual W-2 Managing EmployeeCeo Mar 27, 2017

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2017 Change of OwnershipThis provider was the buyer Pioneer Family Medical of EarlyCCN 118509, GA, NPI 1720393895

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1912430224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11045 COLUMBIA ST",
            "address_2": "SUITE B",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398233447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11045 COLUMBIA ST",
            "address_2": "SUITE B",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398233447",
            "telephone_number": "229-723-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRITE HOSPITAL GROUP OF EARLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-849-6440"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBrite Family Medical of Early",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LifeBrite Family Medical of Early",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blakely, GA

Sources for this page

Verify at the official NPI Registry.