Individual provider Active NPI

Ashraf Attalla, MD

  • Psychiatry Physician
  • Smyrna, GA
National Provider Identifier
1417067489
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
54960 Issued in GA
Practice address
696 Concord Rd SE
Smyrna, GA 30082-2629
Phone
(770) 319-8013
Fax
(770) 319-8021
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 054960 GA
Psychiatry Physician 2084P0800X 54960 GA Primary

Addresses

Primary practice location

696 Concord Rd SE
Smyrna, GA 30082-2629

Mailing address

696 Concord Rd SE
Smyrna, GA 30082-2629
Phone (770) 319-8013

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
54960GAMDPsychiatry Physician
054960GAMDChild & Adolescent Psychiatry Physician
210100MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The Berman Center Past Accepting new patients
Devereux Foundation Past Accepting new patients
Pathways Center for Behavioral & Developmental Growth PastSince Nov 24, 2019 Accepting new patients
Institute for Behavioral Medicine Past Accepting new patients
Psychiatric Associates of Malden, P.C. Psychiatry Past Accepting new patients

Organizations & group practices 5

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1417067489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 CONCORD RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300822629",
            "telephone_number": "770-319-8013",
            "fax_number": "770-319-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 CONCORD RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300822629",
            "telephone_number": "770-319-8013",
            "fax_number": "770-319-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTALLA",
        "first_name": "ASHRAF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "GA",
            "license": "054960",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "54960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.