Individual provider Active NPI

Sandra K Roberson, MD

  • Allergy & Immunology Physician
  • Woodstock, GA
National Provider Identifier
1023042140
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
34232 Issued in GA
Practice address
100 Stoneforest Dr Ste 220
Woodstock, GA 30189-4881
Phone
(770) 953-3331
Fax
(770) 924-5890
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 34232 GA Primary

Addresses

Primary practice location

100 Stoneforest Dr Ste 220
Woodstock, GA 30189-4881

Mailing address

8200 Roberts Dr Ste 450
Sandy Springs, GA 30350-4115
Phone (770) 952-8612

Other identifiers 1

IdentifierTypeStateIssuer
00461084DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120328000282 GA Practitioner - Allergy/Immunology 2365602489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of South Carolina School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

114 Townpark Dr NW
Suite 240
Kennesaw, GA 30144-5802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34232GAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Allergy & Asthma Clinic PA Allergy & Immunology CurrentSince Mar 4, 2010 Accepting new patients
Carolinas Physicians Network Inc Allergy & Immunology Past Accepting new patients

Locations

2045 Peachtree Rd NE
Ste 800
Atlanta, GA 30309
Phone (404) 351-5711

2300 Henderson Mill Rd NE
Ste 230
Atlanta, GA 30345
Phone (770) 491-9300

1620 Mulkey Rd
Ste 100
Austell, GA 30106
Phone (770) 948-3774

100 Old Ball Ground Hwy
#B
Canton, GA 30114
Phone (770) 720-8000

2089 Teron Trce
Ste 250
Dacula, GA 30019
Phone (678) 801-4838

1240 Highway 54 W
Ste 310
Fayetteville, GA 30214
Phone (770) 461-6400

6300 Hospital Pkwy
Ste 250
Johns Creek, GA 30097
Phone (770) 495-6258

114 Townpark Dr NW
Ste 240
Kennesaw, GA 30144
Phone (770) 485-3723

600 Professional Dr
Ste 210
Lawrenceville, GA 30046
Phone (770) 963-8030

1121 Johnson Ferry Rd
Bldg 1
Marietta, GA 30068
Phone (678) 718-2940

790 Church St NE
Ste 150
Marietta, GA 30060
Phone (770) 422-4268

1121 Johnson Ferry Rd
Ste 300
Marietta, GA 30068
Phone (770) 973-5252

1519 Johnson Ferry Rd
Ste 200
Marietta, GA 30062
Phone (770) 973-5578

14 Riverbend Dr SW
Rome, GA 30161
Phone (706) 234-0094

1357 Hembree Rd
Ste 200
Roswell, GA 30076
Phone (770) 475-0807

8200 Roberts Dr
Ste 450
Sandy Springs, GA 30350

800 Mount Vernon Hwy NE
Ste 390
Sandy Springs, GA 30328
Phone (404) 252-4207

830 Eagles Landing Pkwy
Ste 203
Stockbridge, GA 30281
Phone (478) 746-2888

1272 Virgil Langford Rd
Ste 202
Watkinsville, GA 30677
Phone (770) 880-6955

100 Stoneforest Dr
Ste 220
Woodstock, GA 30189
Phone (770) 924-0096

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJBFBA
  • Direct secure messaging: sandra.roberson@atlantaallergy.eclinicaldirectplus.com

Organizations & group practices 2

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1023042140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 ROBERTS DR STE 450",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303504115",
            "telephone_number": "770-952-8612",
            "fax_number": "678-803-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STONEFOREST DR STE 220",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894881",
            "telephone_number": "770-953-3331",
            "fax_number": "770-924-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "SANDRA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "34232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00461084D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.