Individual provider Active NPI

Daniel Keith Ralston, M.D.

  • Family Medicine Physician
  • Decatur, GA
National Provider Identifier
1710333257
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
84078 Issued in GA
Practice address
1829 Lawrenceville Hwy
Decatur, GA 30033-5728
Phone
(404) 292-8335
NPI assigned
May 13, 2016
Last updated
Feb 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 84078 GA Primary

Addresses

Primary practice location

1829 Lawrenceville Hwy
Decatur, GA 30033-5728

Mailing address

1829 Lawrenceville Hwy
Decatur, GA 30033-5728
Phone (404) 292-8335

Other practice location 1

4500 N Shallowford Rd
Suite B
Dunwoody, GA 30338
Phone (404) 778-6920

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
I20200114001906 GA Practitioner - Family Practice 7911332275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

1829 Lawrenceville Hwy
Decatur, GA 30033-5728
Phone (404) 292-8335

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84078GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Immediate Care FP, LLC Family Medicine CurrentSince Nov 20, 2019 Accepting new patients
Peachtree Immediate Care UC, LLC Past Accepting new patients

Locations

1829 Lawrenceville Hwy
Decatur, GA 30033
Phone (404) 292-8335

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

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, 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": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1710333257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 LAWRENCEVILLE HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335728",
            "telephone_number": "404-292-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 LAWRENCEVILLE HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335728",
            "telephone_number": "404-292-8335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 N Shallowford Rd",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Dunwoody",
            "state": "GA",
            "postal_code": "30338",
            "country_code": "US",
            "telephone_number": "404-778-6920",
            "fax_number": "404-778-6901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RALSTON",
        "first_name": "DANIEL",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "84078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.