Anna T Deriso, RNC, WHNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN146512 NP Issued in GA

Practice address

77 Collier Rd NW
Suite 2050
Atlanta, GA 30309-1764

Phone

(404) 351-1002

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anna.deriso.1@6853.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/6853/brand/1/csg/1/fhir/r4

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.

• Atlanta Breast Care, PC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1134288368
  Medicare reassignment NPD

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689733909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 PEACHTREE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052752",
            "telephone_number": "404-869-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 COLLIER RD NW",
            "address_2": "SUITE 2050",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091764",
            "telephone_number": "404-351-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERISO",
        "first_name": "ANNA",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "RNC, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN146512 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyne Deras de Guillen
• Brian Derby, M.D.
• Richard S Derby, LPC
• Stephanie Deren
• Terry Derias, MD
• Dermatology Affiliates, LLC
• Dermatology Associates of Atlanta
• Dermatology Boutique LLC
• Dermatology Consultants, P.C.
• Dermyne & Dwyer LLC

• Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.