Individual provider Active NPI

Debora Lou Coursey-Prah, MD

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1003891037
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
29432 Issued in GA
Practice address
1968 Peachtree Rd NW
Radiology Department
Atlanta, GA 30309-1281
Phone
(404) 605-5000
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 29432 GA Primary

Addresses

Primary practice location

1968 Peachtree Rd NW
Radiology Department
Atlanta, GA 30309-1281

Mailing address

2555 Ponce de Leon Blvd
4TH Floor
Coral Gables, FL 33134-6010
Phone (305) 702-5135

Other practice location 1

655 Jesse Jewell Pkwy SE Ste B
Gainesville, GA 30501-3854
Phone (770) 053-5939

Other practice location 2

1270 Friendship Rd
Braselton, GA 30517-5630
Phone (770) 535-9391

Other practice location 3

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (770) 535-9391

Other identifiers 1

IdentifierTypeStateIssuer
000364361BMedicaidGA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29432GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of Atlanta, PA Diagnostic Radiology Past Accepting new patients

Organizations & group practices 1

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1003891037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 PONCE DE LEON BLVD",
            "address_2": "4TH FLOOR",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331346010",
            "telephone_number": "305-702-5135",
            "fax_number": "305-441-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD NW",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "404-605-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 Jesse Jewell Pkwy SE Ste B",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013854",
            "country_code": "US",
            "telephone_number": "770-053-5939",
            "fax_number": "770-533-4701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1270 Friendship Rd",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175630",
            "country_code": "US",
            "telephone_number": "770-535-9391",
            "fax_number": "770-533-4701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Jesse Jewell Pkwy SE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013834",
            "country_code": "US",
            "telephone_number": "770-535-9391",
            "fax_number": "770-533-4701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COURSEY-PRAH",
        "first_name": "DEBORA",
        "middle_name": "LOU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "29432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000364361B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.