Individual provider Active NPI

Deanna Lynne Roy, M.D.

  • Family Medicine Physician
  • Stone Mountain, GA
National Provider Identifier
1437197761
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34701 Issued in GA
Practice address
1505 Lilburn Stone Mountain Rd
Ste 100
Stone Mountain, GA 30087-1857
Phone
(770) 469-4131
Fax
(770) 469-3931
NPI assigned
Jun 2, 2006
Last updated
Oct 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34701 GA Primary

Addresses

Primary practice location

1505 Lilburn Stone Mountain Rd
Ste 100
Stone Mountain, GA 30087-1857

Mailing address

1505 Lilburn Stone Mountain Rd
Ste 100
Stone Mountain, GA 30087-1857
Phone (770) 469-4131

Other identifiers 1

IdentifierTypeStateIssuer
000469301JMedicaidGA

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
I20051102000043 GA Practitioner - Family Practice 8123045754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Meharry Medical College School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1505 Lilburn Stone Mountain Rd
Suite 100
Stone Mountain, GA 30087-1857
Phone (770) 469-4131

1835 E Park Place Blvd
Suite 110
Stone Mountain, GA 30087-3457
Phone (770) 469-4131

3340 Paddock Pkwy
Suwanee, GA 30024-9119
Phone (678) 679-6210

3350 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (678) 474-9633

3380 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (678) 474-9633

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34701GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services, LLC CurrentSince May 27, 2021 Accepting new patients
Northside Primary Care Professional Services,LLC Family Medicine Current Accepting new patients
Perimeter North Family Practice LLC Family Medicine PastSince Aug 5, 2012 Accepting new patients

Locations

4062 Peachtree Rd NE
Ste C
Brookhaven, GA 30319
Phone (404) 231-4231

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

Interoperability endpoints

  • Direct secure messaging: deanna.roy@northatlantamedical.directbygreenway.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1437197761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 LILBURN STONE MOUNTAIN RD",
            "address_2": "STE 100",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871857",
            "telephone_number": "770-469-4131",
            "fax_number": "770-469-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 LILBURN STONE MOUNTAIN RD",
            "address_2": "STE 100",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871857",
            "telephone_number": "770-469-4131",
            "fax_number": "770-469-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "DEANNA",
        "middle_name": "LYNNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "34701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000469301J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.