Deavmed L.L.C

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DEAVMED L.L.C

Doing business as

Vitality Springs Family Practice

Practice address

3915 Cascade Rd SW Ste T-90
Atlanta, GA 30331-8660

Phone

(770) 925-5884

Fax

(888) 440-7722

NPI assigned

Oct 24, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Todd Deavens, MD

Title

Owner/Member

Phone

(770) 925-5884

Specialties & licenses 2

Addresses

Other names 1

• Vitality Springs Family Practice Doing business as

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1487297164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 BOURDON BELL DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300137459",
            "telephone_number": "770-925-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW STE T-90",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318660",
            "telephone_number": "770-925-5884",
            "fax_number": "888-440-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAVMED L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "DEAVENS",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "770-925-5884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitality Springs Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tonia Dearman, LCSW
• Amanda Dearmond, APRN
• Dale Shelton Deas Jr., MD
• Melika Zarei Deaton, MD
• Todd Wesley Deavens, M.D.
• Anthony J Debalsi
• Dorothy Travasos Debardeleben, PT, DPT
• Austin Claude Debeaux, MD
• Haben Debessai
• Pradipta Debnath, MD

• Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.