Individual provider Active NPI

Brian E Earley, DO

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1972522803
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
95535 Issued in GA
Practice address
1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1649
Phone
(404) 836-0136
Fax
(404) 850-8695
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 95535 GA Primary
Family Medicine Physician 207Q00000X OS 11295 FL
Family Medicine Physician 207Q00000X DO3953 TN

Addresses

Primary practice location

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1649

Mailing address

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1649
Phone (404) 836-0136

Other practice location 1

7205 SE Maricamp Rd
Ocala, FL 34472-2105
Phone (352) 680-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200519003245 TN Practitioner - Family Practice 9335100601 Reassigns benefits to 1 organization
I20230531001043 GA Practitioner - Family Practice 9335100601 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 11295FLMDFamily Medicine Physician
95535GAMDFamily Medicine Physician
DO3953TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Jencare Neighborhood Medical Center West End, LLC CurrentSince Jun 1, 2023 Accepting new patients
PMR Georgia Holding, LLC CurrentSince Jun 1, 2023 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310
Phone (404) 419-0184

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

917 W Walnut St
Johnson City, TN 37604
Phone (423) 439-6464

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1972522803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 RALPH DAVID ABERNATHY BLVD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101649",
            "telephone_number": "404-836-0136",
            "fax_number": "404-850-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 RALPH DAVID ABERNATHY BLVD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101649",
            "telephone_number": "404-836-0136",
            "fax_number": "404-850-8695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7205 SE Maricamp Rd",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344722105",
            "country_code": "US",
            "telephone_number": "352-680-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EARLEY",
        "first_name": "BRIAN",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "95535",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS 11295",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO3953",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.