Individual provider Active NPI

Llewellyn Rachel Delsarte

  • Family Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1437735800
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
99987 Issued in GA
Practice address
665 Duluth Hwy Ste 401
Lawrenceville, GA 30046-4303
Phone
(678) 312-1000
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 99987 GA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

665 Duluth Hwy Ste 401
Lawrenceville, GA 30046-4303

Mailing address

PO Box 1190
Lawrenceville, GA 30046-1190

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
I20240802002641 GA Practitioner - Family Practice 5698176501 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12990GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services,LLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Jul 1, 2024 Accepting new patients
Northside Urgent Care Holding, LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

1110 W Peachtree St NW
Ste 200B
Atlanta, GA 30309
Phone (404) 575-2000

1110 W Peachtree St NW
Ste 200
Atlanta, GA 30309
Phone (404) 575-2000

81 Northside Dawson Dr
Ste 100A
Dawsonville, GA 30534
Phone (706) 216-6000

665 Duluth Hwy
Ste 401
Lawrenceville, GA 30046
Phone (678) 312-0450

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

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

Interoperability endpoints

  • Direct secure messaging: llewellyn.delsarte@450368864321540.direct.elationemr.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1437735800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1190",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300461190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 DULUTH HWY STE 401",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464303",
            "telephone_number": "678-312-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELSARTE",
        "first_name": "LLEWELLYN",
        "middle_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "99987",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.