Individual provider Active NPI

Alana Michele Villada, DO

  • Adult Medicine Physician
  • Buford, GA
National Provider Identifier
1578069076
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
1578069076 Issued in NC
Practice address
4700 Nelson Brogdon Blvd
Buford, GA 30518-5400
Phone
(678) 341-6380
Fax
(678) 288-1064
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Adult Medicine Physician 207QA0505X 1578069076 NC Primary

Addresses

Primary practice location

4700 Nelson Brogdon Blvd
Buford, GA 30518-5400

Mailing address

4700 Nelson Brogdon Blvd
Buford, GA 30518-5400
Phone (678) 431-6380

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
I20220510001151 GA Practitioner - Family Practice 2264864073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, New York, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Practice addresses (Care Compare)

4700 Nelson Brogdon Blvd
Suite 250
Buford, GA 30518-6735
Phone (770) 442-1911

Hospital & facility affiliations

  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1578069076NCMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince May 16, 2022 Accepting new patients

Locations

3400 Old Milton Pkwy
Ste 270
Alpharetta, GA 30005
Phone 7704421911262

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

4700 Nelson Brogdon Blvd
Ste 250
Buford, GA 30518
Phone (678) 341-6380

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1578069076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 NELSON BROGDON BLVD",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305185400",
            "telephone_number": "678-431-6380",
            "fax_number": "678-288-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 NELSON BROGDON BLVD",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305185400",
            "telephone_number": "678-341-6380",
            "fax_number": "678-288-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLADA",
        "first_name": "ALANA",
        "middle_name": "MICHELE",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NC",
            "license": "1578069076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

Verify at the official NPI Registry.