Individual provider Active NPI

Evelyn Akinsanmi Darius, M.D.

  • Family Medicine Physician
  • Austell, GA
National Provider Identifier
1124219696
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
80155 Issued in GA
Practice address
3640 Tramore Pointe Pkwy
Austell, GA 30106-6825
Phone
(404) 365-0966
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
Family Medicine Physician 207Q00000X 80155 GA Primary

Addresses

Primary practice location

3640 Tramore Pointe Pkwy
Austell, GA 30106-6825

Mailing address

1612 Old Hunters Trce
Marietta, GA 30062-6170
Phone (423) 829-1089

Other practice location 1

3401 S Harbor Blvd
suite 210
Santa Ana, CA 92704-7933
Phone (714) 830-6680

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
I20181101001094 GA Practitioner - Family Practice 2264620616 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80155GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Family Medicine CurrentSince Jul 2, 2018 Accepting new patients

Locations

1745 Peachtree St NE
Ste U
Atlanta, GA 30309
Phone (404) 545-5161

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

3640 Tramore Pointe Pkwy
Austell, GA 30106
Phone (770) 439-4700

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1124219696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 OLD HUNTERS TRCE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626170",
            "telephone_number": "423-829-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 TRAMORE POINTE PKWY",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066825",
            "telephone_number": "404-365-0966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 S Harbor Blvd",
            "address_2": "suite 210",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927047933",
            "country_code": "US",
            "telephone_number": "714-830-6680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARIUS",
        "first_name": "EVELYN",
        "middle_name": "AKINSANMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "80155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.