Individual provider Active NPI

Andre J Roy, RN,NP

  • Critical Care Medicine Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1588792014
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
RN140214NP Issued in GA
Practice address
59 Executive Park South NE
Suite 2085
Atlanta, GA 30329-2208
Phone
(404) 778-6283
Fax
(404) 778-7208
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X RN140214NP GA Primary

Addresses

Primary practice location

59 Executive Park South NE
Suite 2085
Atlanta, GA 30329-2208

Mailing address

59 Executive Park South NE
Suite 2085
Atlanta, GA 30329-2208
Phone (404) 778-6283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN140214NPGAMDCritical Care Medicine Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588792014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK SOUTH NE",
            "address_2": "SUITE 2085",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-6283",
            "fax_number": "404-778-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK SOUTH NE",
            "address_2": "SUITE 2085",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-6283",
            "fax_number": "404-778-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "ANDRE",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "RN,NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "GA",
            "license": "RN140214NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.