Individual provider Active NPI

Clay Ditty, ACNP

  • Acute Care Nurse Practitioner
  • Stockbridge, GA
National Provider Identifier
1316223829
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN246944 Issued in GA
Practice address
1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone
(404) 367-3014
Fax
(404) 367-3558
NPI assigned
Oct 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN246944 GA Primary

Addresses

Primary practice location

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085

Mailing address

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (404) 367-3014

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151009001625 GA Practitioner - Nurse Practitioner 3971763426 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Duke University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare Inc CurrentSince Mar 14, 2016 Accepting new patients
Piedmont Specialty Hospital Billing LLC CurrentSince Apr 1, 2018 Accepting new patients
Piedmont Cardiology of Atlanta, LLC CurrentSince Jun 8, 2015 Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1984 Peachtree Rd NW
Ste 205
Atlanta, GA 30309

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1316223829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815085",
            "telephone_number": "404-367-3014",
            "fax_number": "404-367-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815085",
            "telephone_number": "404-367-3014",
            "fax_number": "404-367-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTY",
        "first_name": "CLAY",
        "name_prefix": "Mr.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-27",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN246944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.