Individual provider Active NPI

Alejandra Grullon, MD

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1376124834
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
104588 Issued in GA
Practice address
550 Pharr Rd NE Ste 605
Atlanta, GA 30305-3469
Phone
(404) 727-5157
Fax
(678) 705-2756
NPI assigned
Apr 16, 2021
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 104588 GA Primary

Addresses

Primary practice location

550 Pharr Rd NE Ste 605
Atlanta, GA 30305-3469

Mailing address

550 Pharr Rd NE Ste 605
Atlanta, GA 30305-3469

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251016002110 GA Practitioner - Psychiatry 2163823071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

445 Winn Way
Decatur, GA 30030-1707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
Dekalb Community Service Board CurrentSince Dec 1, 2025 Accepting new patients
Emory Medical Care Foundation Inc Psychiatry CurrentSince Oct 1, 2025 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Oct 1, 2025 Accepting new patients

Locations

12 Executive Park Dr NE
Ste 142
Atlanta, GA 30329
Phone (404) 727-5157

23 Warren St SE
Atlanta, GA 30317
Phone (404) 370-7474

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

445 Winn Way
Decatur, GA 30030
Phone (404) 294-3745

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1376124834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PHARR RD NE STE 605",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303053469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PHARR RD NE STE 605",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303053469",
            "telephone_number": "404-727-5157",
            "fax_number": "678-705-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRULLON",
        "first_name": "ALEJANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "104588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.