Active NPI
Deborah Lyn Levich, MD
- Gynecology Physician
- Roswell, GA
National Provider Identifier
1376643908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 44520
- Practice address
- 1102 Macy Dr
Roswell, GA 30076-6351 - Phone
- (678) 218-1710
- Fax
- (678) 218-1714
- NPI assigned
- Sep 24, 2006
- Last updated
- Mar 26, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 44520 | GA | Primary |
Addresses
Primary practice location
1102 Macy Dr
Roswell, GA 30076-6351
Mailing address
PO Box 566813
Atlanta, GA 31156-6813
Phone (678) 218-1710
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000757798I | Medicaid | GA |
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
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44520 | GA | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metamorphosis Medical Group | Past | Accepting new patients | |
| Atlanta Oral & Facial Surgery LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Medical Specialty Clinic/Center
- Roswell, GA
- NPI 1538458690
-
- Oral and Maxillofacial Surgery (Dentist)
- Marietta, GA
- NPI 1992738165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364256000000",
"number": "1376643908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 566813",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311566813",
"telephone_number": "678-218-1710",
"fax_number": "678-218-1714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 MACY DR",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300766351",
"telephone_number": "678-218-1710",
"fax_number": "678-218-1714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVICH",
"first_name": "DEBORAH",
"middle_name": "LYN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-24",
"last_updated": "2013-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "GA",
"license": "44520",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000757798I",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.