Dekisha Pendergrass Drayton, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

053016 Issued in GA

Practice address

3885 Princeton Lakes Way
Suite 302
Atlanta, GA 30331

Phone

(404) 629-1880

Fax

(404) 629-1935

NPI assigned

Oct 4, 2006

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

Other identifiers 1

Other names 1

• Dekisha M. Pendergrass Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: dekisha.drayton.1@33990.direct.athenahealth.com

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1306931548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6279 VININGS VINTAGE DR",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301267202",
            "telephone_number": "404-394-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3885 PRINCETON LAKES WAY",
            "address_2": "SUITE 302",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30331",
            "telephone_number": "404-629-1880",
            "fax_number": "404-629-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAYTON",
        "first_name": "DEKISHA",
        "middle_name": "PENDERGRASS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "053016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118918947B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEKISHA",
            "last_name": "PENDERGRASS",
            "middle_name": "M.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Michael Drake, MD
• Siyama Drake, LPC
• Daniel Louis Drane, PH.D.
• Elizabeth Draper, PAAA
• Drayton Medical Care Inc
• Ivorie Alexis Drayton, M.D.
• Joyce R. Drayton, M.D.
• Kai Drayton
• Dream Again Therapy Services LLC
• Dream Breast Care Center LLC

• Pediatrics Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.