Organization Active NPI

Alcovy Neurology

  • Neurology Physician
  • Loganville, GA
National Provider Identifier
1225329667
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
ALCOVY NEUROLOGY
Practice address
3525 Highway 81
Loganville, GA 30052-4336
Phone
(678) 905-9625
Fax
(770) 674-5880
NPI assigned
Apr 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Juan Carlos Lacayo, MDNPI 1245427178
Title
Neurologist
Phone
(678) 905-9625

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

3525 Highway 81
Loganville, GA 30052-4336

Mailing address

3525 Highway 81
Loganville, GA 30052-4336
Phone (678) 905-9625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111107000542 GA Part B Supplier - Clinic/Group Practice 8224201231 Receives reassigned benefits from 3 practitioners
Practice locations: Loganville, GA

National Provider Directory

National Provider Directory

Locations

3525 Highway 81
Loganville, GA 30052
Phone (678) 325-1074

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3403/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1225329667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 HIGHWAY 81",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524336",
            "telephone_number": "678-905-9625",
            "fax_number": "770-674-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 HIGHWAY 81",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524336",
            "telephone_number": "678-905-9625",
            "fax_number": "770-674-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALCOVY NEUROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-20",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "LACAYO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "CARLOS",
        "authorized_official_title_or_position": "NEUROLOGIST",
        "authorized_official_telephone_number": "678-905-9625",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.