Carissa Merea Duvall, MSN, APRN, AGPCNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN330541 Issued in GA

Practice address

2941 Piedmont Rd NE Ste B
Atlanta, GA 30305-2784

Phone

(404) 841-9445

NPI assigned

Oct 8, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

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.

• Ageless Mens Health

  • Medical Physician Assistant
  • Atlanta, GA
  • NPI 1518281864
  NPD (past)
• Ageless Men'S Health, LLC

  • Clinical Medical Laboratory
  • Memphis, TN
  • NPI 1003098997
  NPD (past)

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1427877281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4903 JUDITH AVE SE",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301022867",
            "telephone_number": "678-477-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2941 PIEDMONT RD NE STE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052784",
            "telephone_number": "404-841-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVALL",
        "first_name": "CARISSA",
        "middle_name": "MEREA",
        "credential": "MSN, APRN, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN330541",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN330541",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN330541",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN330541",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Duszak Jr., M.D.
• Giselle Marie Almeida Dutcher, MD
• Indira Dutchin
• Monica Dutke
• Eamon K Dutta, M.D.
• Diane V Duvall, M.D.
• Dalyngs Duvelsaint
• Yazan Duwayri, M.D.
• Dva Healthcare Renal Care Inc
• Dva Healthcare Renal Care Inc

• Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.