Active NPI
Edgar Robin Bohannon, DOCTOR OF AUDIOLOGY
- Audiologist
- Augusta, GA
National Provider Identifier
1922062702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 65
- Practice address
- 1215 George C Wilson Dr
Suite 3a
Augusta, GA 30909-5700 - Phone
- (706) 364-2384
- Fax
- (706) 364-2380
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 65 | GA | Primary |
Addresses
Primary practice location
1215 George C Wilson Dr
Suite 3a
Augusta, GA 30909-5700
Mailing address
1215 George C Wilson Dr
Suite 3a
Augusta, GA 30909-5700
Phone (706) 364-2384
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 703515 | Other | GA | BLUE SHIELD PROVIDER NO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65 | GA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1922062702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 GEORGE C WILSON DR",
"address_2": "SUITE 3A",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309095700",
"telephone_number": "706-364-2384",
"fax_number": "706-364-2380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 GEORGE C WILSON DR",
"address_2": "SUITE 3A",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309095700",
"telephone_number": "706-364-2384",
"fax_number": "706-364-2380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHANNON",
"first_name": "EDGAR",
"middle_name": "ROBIN",
"credential": "DOCTOR OF AUDIOLOGY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "GA",
"license": "65",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER NO",
"identifier": "703515",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.