Individual provider Active NPI

Deirdre Evans-Cosby, MD

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1124029798
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
055397 Issued in GA
Practice address
1800 Howell Mill Rd NW
Ste 275
Atlanta, GA 30318-2538
Phone
(404) 756-1400
Fax
(404) 756-5252
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 055397 GA Primary

Addresses

Primary practice location

1800 Howell Mill Rd NW
Ste 275
Atlanta, GA 30318-2538

Mailing address

75 Piedmont Ave
Ste 700
Atlanta, GA 30303-2544
Phone (404) 756-5271

Other identifiers 2

IdentifierTypeStateIssuer
334204431FMedicaidGA
334204431DMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050221000352 GA Practitioner - Psychiatry 3476505249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Meharry Medical College School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morehouse Healthcare, Inc.Group PAC ID 6002701273, 155 clinicians

Practice addresses (Care Compare)

1595 W Cleveland Ave
East Point, GA 30344-3200
Phone (404) 305-8086

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055397GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morehouse Healthcare, Inc. Psychiatry CurrentSince Aug 1, 2004 Accepting new patients

Locations

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

1800 Howell Mill Rd NW
Ste 275
Atlanta, GA 30318
Phone (404) 287-0054

75 Piedmont Ave NE
Ste 700
Atlanta, GA 30303
Phone (404) 756-1410

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

Organizations & group practices 1

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1124029798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PIEDMONT AVE",
            "address_2": "STE 700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303032544",
            "telephone_number": "404-756-5271",
            "fax_number": "404-756-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOWELL MILL RD NW",
            "address_2": "STE 275",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303182538",
            "telephone_number": "404-756-1400",
            "fax_number": "404-756-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS-COSBY",
        "first_name": "DEIRDRE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "055397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "334204431F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "334204431D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.