DR. EBON ANTHONY BOURNE (M.D.) – Internal Medicine Physician, NPI 1225178825
Internal Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
5,409 INTERNAL MEDICINE in GA
Provider Addresses for DR. EBON ANTHONY BOURNE (M.D.)
4550 COBB PARKWAY NORTH NW
SUITE 205
ACWORTH, GA 301014143
Phone: (770) 917-8160
Fax: (770) 529-1167
Type: Mailing
3225 CUMBERLAND BLVD SE STE 550
ATLANTA, GA 303396069
Phone: (404) 419-9970
Fax: (404) 252-8930
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 327 Open Payments records for all available years, with a total value of $67,763.
Total Amount is formed as General ($67,763) + Research ($0) + Ownership ($0) = $67,763.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Lilly USA, LLC ($62,514).
Total Amount
$67,763
General + Research + Ownership
Payments
327
Total payment records
General Amount
$67,763
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $62,514 |
| Eli Lilly and Company | $1,950 |
| PFIZER INC. | $801 |
| ABBVIE INC. | $544 |
| Amgen Inc. | $250 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-11-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20121116000080 | I | Internal Medicine | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 307 | 234 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 256 | 256 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 191 | 153 | $0 |
| G0008 | Administration of influenza virus vaccine | 72 | 71 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 70 | 69 | $0 |
Insurance plans in this area (ZIP 30101)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | GA | 90670 | Pneumococcal vaccine for injection into muscle | 104 | 104 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| - | GA | |
| - | GA | |
| R H E U M A T O L O G Y | MI | |
| Hospitalist, Internal Medicine | GA | |
| Nurse Practitioner | TN | |
| Family Practice | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Hospitalist, Internal Medicine | GA |
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