Individual provider Active NPI

Deandra McDuffie, DNP, NP-C

  • Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1326311895
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN208108 Issued in GA
Practice address
771 Old Norcross Rd Ste 225
Lawrenceville, GA 30046-4982
Phone
(678) 802-4045
NPI assigned
Feb 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN208108 GA Primary

Addresses

Primary practice location

771 Old Norcross Rd Ste 225
Lawrenceville, GA 30046-4982

Mailing address

1550 Janmar Rd Ste B
Snellville, GA 30078-5779
Phone (770) 822-3031

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
I20200324003452 GA Practitioner - Nurse Practitioner 6204264203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Practice addresses (Care Compare)

771 Old Norcross Rd
Suite 225
Lawrenceville, GA 30005-4414
Phone (770) 442-1911

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN208108GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince Jul 1, 2023 Accepting new patients
Progressive Healthcare & Diagnostics, LLC CurrentSince Mar 18, 2020 Accepting new patients
Heal Doctors Ihwa, P.C. PastSince Oct 6, 2020 Accepting new patients
Physician First Health Network PastSince Jun 3, 2025 Accepting new patients

Locations

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

4646 N Shallowford Rd
Dunwoody, GA 30338
Phone (770) 676-6000

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

771 Old Norcross Rd
Ste 225
Lawrenceville, GA 30046
Phone (678) 802-4045

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1326311895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 JANMAR RD STE B",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785779",
            "telephone_number": "770-822-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD STE 225",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464982",
            "telephone_number": "678-802-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDUFFIE",
        "first_name": "DEANDRA",
        "name_prefix": "Dr.",
        "credential": "DNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-14",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN208108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.