Individual provider Active NPI

Demetria Woodruff, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1679464523
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
GAA-NP003770 Issued in GA
Practice address
160 Carnegie PL
Fayetteville, GA 30214-3905
Phone
(470) 435-8028
Fax
(770) 670-5342
NPI assigned
Jul 10, 2025
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X GAA-NP003770 GA Primary

Addresses

Primary practice location

160 Carnegie PL
Fayetteville, GA 30214-3905

Mailing address

1121 Johnson Ferry Road
Suite 450
Marietta, GA 30068

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
GAA-NP003770GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metris True and Noble Minds LLC. Psychiatric/Mental Health Current Accepting new patients
Avant Behavioral Consultants Inc CurrentSince Jul 13, 2025 Accepting new patients
Greater Georgia Behavioral Health PastSince Nov 7, 2025 Accepting new patients

Locations

1121 Johnson Ferry Rd
Ste 450
Marietta, GA 30068
Phone (770) 973-8911

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1679464523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 JOHNSON FERRY ROAD",
            "address_2": "SUITE 450",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CARNEGIE PL",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143905",
            "telephone_number": "470-435-8028",
            "fax_number": "770-670-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "DEMETRIA",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-10",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "GAA-NP003770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.