Individual provider Active NPI

Denise Cheryl De Veranez, MD

  • Internal Medicine Physician
  • Ellenwood, GA
National Provider Identifier
1659409043
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
041279 Issued in GA
Practice address
4477 W Village Pkwy
Ellenwood, GA 30294-2869
Phone
(404) 366-9311
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 041279 GA Primary

Addresses

Primary practice location

4477 W Village Pkwy
Ellenwood, GA 30294-2869

Mailing address

285 Country Club Dr
Suite 200
Stockbridge, GA 30281-7350
Phone (770) 507-1414

Other practice location 1

285 Country Club Dr
Suite 200
Stockbridge, GA 30281-7350
Phone (770) 507-1414

Other identifiers 1

IdentifierTypeStateIssuer
00710575EMedicaidGA

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
I20110718000245 GA Practitioner - Internal Medicine 4385812445 Reassigns benefits to 1 organization
Practice locations: Stockbridge, GA

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation Internal Medicine CurrentSince Jul 25, 2022 Accepting new patients
Piedmont Providers LLC Internal Medicine PastSince Jul 17, 2022 Accepting new patients
Denise C. de Veranez, M.D., P.C. Internal Medicine PastSince Jan 6, 2000 Accepting new patients

Locations

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

4477 W Village Pkwy
Ellenwood, GA 30294
Phone (404) 366-9311

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.

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": "1657670400000",
    "number": "1659409043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 COUNTRY CLUB DR",
            "address_2": "SUITE 200",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817350",
            "telephone_number": "770-507-1414",
            "fax_number": "770-507-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 W VILLAGE PKWY",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942869",
            "telephone_number": "404-366-9311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "285 Country Club Dr",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302817350",
            "country_code": "US",
            "telephone_number": "770-507-1414",
            "fax_number": "770-507-5150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE VERANEZ",
        "first_name": "DENISE",
        "middle_name": "CHERYL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "041279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00710575E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

Verify at the official NPI Registry.