Active NPI
Roger B Sealey, CO
- Specialist
- Decatur, GA
National Provider Identifier
1366609778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 000061
- Practice address
- 1670 Clairmont Rd
Decatur, GA 30033-4004 - Phone
- (404) 321-6111
- NPI assigned
- May 22, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 000061 | GA | Primary |
Addresses
Primary practice location
1670 Clairmont Rd
Decatur, GA 30033-4004
Mailing address
12 Applewood Dr
Hampton, VA 23666-2890
Phone (757) 303-8855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000061 | GA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1366609778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 APPLEWOOD DR",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236662890",
"telephone_number": "757-303-8855",
"fax_number": "757-325-8221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1670 CLAIRMONT RD",
"city": "DECATUR",
"state": "GA",
"postal_code": "300334004",
"telephone_number": "404-321-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEALEY",
"first_name": "ROGER",
"middle_name": "B",
"name_prefix": "Mr.",
"credential": "CO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-22",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "000061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.