The Emory Johns Creek Hospital Medical Staff Services department and Emory System Credentialing Office work together to provide centralized credentialing services by Emory Healthcare and local medical staff services. Our professional team members strive to maintain an effective credentialing and re-credentialing program. Our goal is to ensure that all of Emory Johns Creek Hospital providers are highly qualified and competent to provide the best patient care in the Southeast.

Emory Credentialing has launched new on-line credentialing software. As part of the new process, ALL initial appointment applicants, modifications, and reappointment applicants must now complete the online version of the application. You will find a credentialing request form linked here (PDF). Please complete this form and return it to the Medical Staff Office (MSO). Once your form is entered into the credentialing system, you will be emailed a link to complete the on-line application.

Creation of a user ID and password will be required. Please note: a unique e-mail address will be required for EACH applicant, as the new system does not allow for multiple applicants/providers to have the same e-mail address. (Office staff/managers: please be aware that this needs to be the physician’s email addresses (not your own) and that all notifications/reminders for re-credentialing/medical staff information will be sent to this email address. If you are the representative that completes the credentialing process for your providers, you will need to make sure you are forwarded any reminders/information or have access to this email account).

In addition to the electronic application, the following are still required and needed for our records. Please fax these documents to Serge Rollins at 404.778.7196:

  • A Current Government Issued ID
  • Schedule A from the Georgia Uniform Application (will be provided in the electronic application)
  • Schedule C from the Georgia Uniform Application (will be provided in the electronic application)
  • Proof of malpractice coverage

For credentialing approval, please allow 90 days from the date the completed application and all required materials are submitted.

EJCH Medical Staff Bylaws

If you have any further questions, please do not hesitate to contact us. Thanks again! We look forward to working with you soon!

Andra Conway
Manager, Medical Staff Services - Emory Johns Creek Hospital
Office: 678.474.7024
Fax: 678.474.7025

Serge Rolin
Credentialing Verification Specialist – Emory Johns Creek Hospital
Office: 678.474.7194
Fax: 678.474.7196

Carrie Burgess
Medical Staff Services Coordinator – Emory Johns Creek Hospital
Office: 678.474.7036
Fax: 678.474.7034