Individual provider Active NPI

Nancy C McRoyal, APRN, BC

  • Family Nurse Practitioner
  • Kennesaw, GA
National Provider Identifier
1316916141
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN091649 Issued in GA
Practice address
2779 Cobb Pkwy NW
Kennesaw, GA 30152-3437
Phone
(877) 935-0333
Fax
(770) 795-1843
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN091649 GA Primary

Addresses

Primary practice location

2779 Cobb Pkwy NW
Kennesaw, GA 30152-3437

Mailing address

2779 Cobb Pkwy NW
Kennesaw, GA 30152-3437
Phone (877) 935-0333

Other identifiers 1

IdentifierTypeStateIssuer
00683724AMedicaidGA

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
I20070416000153 GA Practitioner - Nurse Practitioner 6406951797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

2779 N Cobb Pkwy
Kennesaw, GA 30152-3437
Phone (678) 732-1516

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN091649GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC CurrentSince Aug 1, 2017 Accepting new patients
Take Care Health Georgia, P.C. Family Past Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients
Rediclinic LLC Past Accepting new patients

Locations

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

4120 Austell Rd
Austell, GA 30106
Phone (678) 732-1524

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

2779 N Cobb Pkwy NW
Kennesaw, GA 30152
Phone (678) 732-1516

695 W Crossville Rd
Roswell, GA 30075
Phone (678) 732-1531

Organizations & group practices 4

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316916141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2779 COBB PKWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523437",
            "telephone_number": "877-935-0333",
            "fax_number": "770-795-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2779 COBB PKWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523437",
            "telephone_number": "877-935-0333",
            "fax_number": "770-795-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCROYAL",
        "first_name": "NANCY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN091649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00683724A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.