Individual provider Active NPI

Sarah Elizabeth Derossett, M.D., PHD.

  • Neurology Physician
  • Decatur, GA
National Provider Identifier
1023040417
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
034814 Issued in GA
Practice address
2665 N Decatur Rd
Ste 630
Decatur, GA 30033-6149
Phone
(404) 294-3040
Fax
(404) 294-3050
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 034814 GA Primary

Addresses

Primary practice location

2665 N Decatur Rd
Ste 630
Decatur, GA 30033-6149

Mailing address

2665 N Decatur Rd
Ste 630
Decatur, GA 30033-6149
Phone (404) 294-3040

Other identifiers 1

IdentifierTypeStateIssuer
00476352CMedicaidGA

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)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
034814GAMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023040417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 N DECATUR RD",
            "address_2": "STE 630",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336149",
            "telephone_number": "404-294-3040",
            "fax_number": "404-294-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 N DECATUR RD",
            "address_2": "STE 630",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336149",
            "telephone_number": "404-294-3040",
            "fax_number": "404-294-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSSETT",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D., PHD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "034814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00476352C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.