Myrlene Desrosiers, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN126935 Issued in GA

Practice address

2020 McGee Rd
Snellville, GA 30078-2992

Phone

(877) 749-7428

Fax

(512) 628-3314

NPI assigned

Feb 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• MC Medical LLC

  • General Practice Physician
  • Dallas, GA
  • NPI 1356907695
  NPD (past)

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1104382084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 WOODSTEAD CT STE 208",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801480",
            "telephone_number": "877-749-7428",
            "fax_number": "512-628-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 MCGEE RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782992",
            "telephone_number": "877-749-7428",
            "fax_number": "512-628-3314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2785 Lawrenceville Hwy",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300332515",
            "country_code": "US",
            "telephone_number": "303-292-1144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESROSIERS",
        "first_name": "MYRLENE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN126935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diabetes and Endocrinology of Snellville, LLC

• Family Nurse Practitioner in Snellville, GA
• Providers in Snellville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.