Individual provider Active NPI

Cidjah Rodney-Somersall, MD

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1659562007
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
059751 Issued in GA
Practice address
2695 Buford Hwy NE
Suite 200
Atlanta, GA 30324-3278
Phone
(404) 616-6999
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 059751 GA Primary

Addresses

Primary practice location

2695 Buford Hwy NE
Suite 200
Atlanta, GA 30324-3278

Mailing address

4525 Teresa CT
Lithonia, GA 30038-7702
Phone (678) 471-6938

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
I20230421000073 GA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3577659333

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Past Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Organizations & group practices 2

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1659562007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 TERESA CT",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300387702",
            "telephone_number": "678-471-6938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2695 BUFORD HWY NE",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303243278",
            "telephone_number": "404-616-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODNEY-SOMERSALL",
        "first_name": "CIDJAH",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "059751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.