Dekalb Neurology Group, LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

055713 Issued in GA

Legal business name

DEKALB NEUROLOGY GROUP, LLC

Practice address

2665 N Decatur Rd
Suite 540
Decatur, GA 30033-6149

Phone

(404) 508-4008

Fax

(404) 508-4009

NPI assigned

Apr 18, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Amy Mabe

Title

Office Manager

Phone

(404) 508-4008

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David A. Olson, M.D.

  • Neurology Physician
  • Decatur, GA
  • NPI 1598829830
  Medicare reassignment NPD
• Marshall L. Nash, M.D.

  • Neurology Physician
  • Decatur, GA
  • NPI 1023172665
  NPD (past)

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1649537416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 N DECATUR RD",
            "address_2": "SUITE 540",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336149",
            "telephone_number": "404-508-4008",
            "fax_number": "404-508-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 N DECATUR RD",
            "address_2": "SUITE 540",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336149",
            "telephone_number": "404-508-4008",
            "fax_number": "404-508-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB NEUROLOGY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "MABE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "404-508-4008",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "055713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13BDDXX",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dekalb Medical Occupational Medicine Group LLC
• Dekalb Medical Primary Care Group LLC
• Dekalb Medical Psych Unit
• Dekalb Medical Specialty Care Group LLC
• Dekalb Neurology Associates, LLC
• Dekalb Orthopedic Clinic PA
• Dekalb Pain Center
• Dekalb Pathology PC
• Dekalb Pediatric Center
• Dekalb Rape Crisis Center Inc

• Neurology Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Neurology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.