Renee Alli, MD
Individual provider Active NPI Pediatric Adolescent Medicine Physician · Chamblee, GA
NPI 1003870874 · NPPES record last updated Jun 6, 2022
Key facts
- NPI
- 1003870874
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Adolescent Medicine Physician 2080A0000X
- License
- 51424 (GA)
- Practice address
- 5134 Peachtree Rd
Chamblee, GA 30341-2724 - Phone
- (678) 872-7100
- Fax
- (678) 843-8501
- NPI assigned
- Apr 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230711003184 | GA | Practitioner - Pediatric Medicine | 1254622020 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Joseph'S Mercy Care Services, Inc. | Current |
Accepting new patients | |
| Saint Joseph'S Mercy Care Services, Inc. | Current |
Accepting new patients | |
| Saint Joseph'S Mercy Care Services, Inc. | Current | Accepting new patients | |
| Saint Joseph'S Mercy Care Services Inc | Current | Accepting new patients | |
| Saint Joseph'S Mercy Care Services, Inc. | Current | Accepting new patients |
Locations
1300 Joseph E Boone Blvd NW
Atlanta, GA 30314
Phone (404) 952-1201
275 Pryor St SW
Atlanta, GA 30303
Phone (678) 843-8840
424 Decatur St SE
Atlanta, GA 30312
Phone (678) 843-8500
5134 Peachtree Rd
Chamblee, GA 30341
Phone (678) 872-7100
Interoperability endpoints
- renee.alli@mercyatlanta.gadirect.net
- ralli198792@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 51424 | GA | Yes |
Addresses
Primary practice location
5134 Peachtree Rd
Chamblee, GA 30341-2724
Mailing address
5134 Peachtree Rd
Chamblee, GA 30341-2724
Phone (678) 872-7100
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | choa@choa.gadirect.net |
Other providers in Chamblee, GA
- Thomas Vincent Adamkiewicz
- Advanced Practice Enterprises PC
- Afc Physicians of Georgia, PC
- Adebayo Kolawole Akinsola
- All About Care Transport LLC
- David Almazan
- Aloha Dental Care PC
- Alphamed Medical Transport LLC
- Veneranda N Amin
- Elise L Ashpole
All providers in Chamblee, GA · Pediatric Adolescent Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.