Individual provider Active NPI

Berly Sojan, FNP

  • Family Nurse Practitioner
  • Conyers, GA
National Provider Identifier
1609413152
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN177346 Issued in GA
Practice address
1301 Sigman Rd NE Ste 230
Conyers, GA 30012-3819
Phone
(678) 609-4912
NPI assigned
Dec 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN177346 GA
Family Nurse Practitioner 363LF0000X RN177346 GA Primary

Addresses

Primary practice location

1301 Sigman Rd NE Ste 230
Conyers, GA 30012-3819

Mailing address

3465 Preservation Cir
Lilburn, GA 30047-2066
Phone (678) 925-0837

Other practice location 1

4025 Lawrenceville Hwy NW Ste A
Lilburn, GA 30047-2876
Phone (770) 559-3501

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211229000802 GA Practitioner - Nurse Practitioner 3173914108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

1301 Sigman Rd NE
Suite 230
Conyers, GA 30012-3819
Phone (678) 609-4912

Hospital & facility affiliations

  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN177346GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation CurrentSince Dec 20, 2023 Accepting new patients
Lifeline Primary Care, Inc CurrentSince Sep 23, 2021 Accepting new patients
Lifeline Primary Care, Inc CurrentSince Sep 23, 2021 Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

1301 Sigman Rd NE
Ste 230
Conyers, GA 30012
Phone (678) 609-4912

4025 Lawrenceville Hwy NW
Ste A
Lilburn, GA 30047
Phone (770) 559-3501

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.

Hospital & facility affiliations 1

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": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1609413152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 PRESERVATION CIR",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472066",
            "telephone_number": "678-925-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SIGMAN RD NE STE 230",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123819",
            "telephone_number": "678-609-4912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4025 Lawrenceville Hwy NW Ste A",
            "address_purpose": "LOCATION",
            "city": "Lilburn",
            "state": "GA",
            "postal_code": "300472876",
            "country_code": "US",
            "telephone_number": "770-559-3501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOJAN",
        "first_name": "BERLY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-03",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN177346",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN177346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.