Dekalbcommunityserviceboard

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

021810 Issued in GA

Legal business name

DEKALBCOMMUNITYSERVICEBOARD

Practice address

1662 Kanawha Dr
Stone Mountain, GA 30087-2116

Phone

(404) 243-9500

Fax

(404) 244-2224

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Doddametikur S Siddappa, M.D.

Title

Staff Psychiatrist

Phone

(404) 243-9500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1457565541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1662 KANAWHA DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872116",
            "telephone_number": "404-243-9500",
            "fax_number": "404-244-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1662 KANAWHA DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872116",
            "telephone_number": "404-243-9500",
            "fax_number": "404-244-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALBCOMMUNITYSERVICEBOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "SIDDAPPA",
        "authorized_official_first_name": "DODDAMETIKUR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "STAFF PSYCHIATRIST",
        "authorized_official_telephone_number": "404-243-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "021810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dekalb Community Service Board
• Dekalb County Health Care Center, Inc
• Dekalb County School System
• Dekalb Family Practice, P.C.
• Dekalb Women'S Specialists
• Linda G Dennard, LCSW
• Dentures and Family Dentistry
• Mira Desai, AGPCNP
• Rohit Manubhai Desai, MD
• Tejal Haresh Desai, AA

• Health Maintenance Organization in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Health Maintenance Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.