NPIMap

Individual provider Active NPI

Andrea Roche Gayden, ANP-BC

  • Internal Medicine Physician
  • Lilburn, GA
National Provider Identifier
1053723676
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
RN208594 Issued in GA
Practice address
4120 Five Forks Trickum Rd SW Ste 105
Lilburn, GA 30047-8975
Phone
(770) 921-6900
NPI assigned
Jun 2, 2014
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN208594 GA
Internal Medicine Physician 207R00000X RN208594 GA Primary

Addresses

Primary practice location

4120 Five Forks Trickum Rd SW Ste 105
Lilburn, GA 30047-8975

Mailing address

4120 Five Forks Trickum Rd SW Ste 105
Lilburn, GA 30047-8975
Phone (770) 921-6900

Other names 1

  • Mrs. Andrea Roche' Haynes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160811001724 GA Practitioner - Nurse Practitioner 8729372867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

1699 Hwy 124 N
Suite 100
Snellville, GA 30078-7921
Phone (678) 218-6702

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN208594GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation Internal Medicine CurrentSince Mar 24, 2018 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Mar 24, 2018 Accepting new patients
Emory Specialty Associates, LLC Internal Medicine CurrentSince Aug 18, 2022 Accepting new patients
Dekalb Medical Primary Care Group LLC PastSince May 8, 2022 Accepting new patients
Mountain East Family Medicine PC PastSince Dec 14, 2025 Accepting new patients
Stonecrest Family Medicine PLLC PastSince May 8, 2022 Accepting new patients
Greater Gwinnett Physician Practice Company PastSince Dec 14, 2025 Accepting new patients

Locations

1776 Old Spring House Ln
Atlanta, GA 30338
Phone (770) 454-0091

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

8225 Mall Pkwy
Ste 100
Stonecrest, GA 30038
Phone (770) 981-2100

Interoperability endpoints

  • Direct secure messaging: agayden94249@direct.emory.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1053723676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 FIVE FORKS TRICKUM RD SW STE 105",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300478975",
            "telephone_number": "770-921-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 FIVE FORKS TRICKUM RD SW STE 105",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300478975",
            "telephone_number": "770-921-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYDEN",
        "first_name": "ANDREA",
        "middle_name": "ROCHE",
        "name_prefix": "Ms.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN208594",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "RN208594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "HAYNES",
            "middle_name": "ROCHE'",
            "prefix": "MRS.",
            "credential": "ANP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lilburn, GA

Sources for this page

Verify at the official NPI Registry.