Individual provider Active NPI

Danna Kathryn Conboy Shetty, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1053651455
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8276 Issued in GA
Practice address
993 Johnson Ferry Rd Building F Ste 210
Atlanta, GA 30342-1620
Phone
(404) 256-1727
NPI assigned
Feb 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8276 GA Primary

Addresses

Primary practice location

993 Johnson Ferry Rd Building F Ste 210
Atlanta, GA 30342-1620

Mailing address

993 Johnson Ferry Rd Building F Ste 210
Atlanta, GA 30342-1620
Phone (404) 256-1727

Other names 1

  • Danna Kathryn Conboy Former name

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8276GAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: dshetty246700@directc.mercy.net

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1053651455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "993 JOHNSON FERRY RD BUILDING F STE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421620",
            "telephone_number": "404-256-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "993 JOHNSON FERRY RD BUILDING F STE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421620",
            "telephone_number": "404-256-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "DANNA",
        "middle_name": "KATHRYN CONBOY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANNA",
            "last_name": "CONBOY",
            "middle_name": "KATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 23, 2018; 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.