Organization Active NPI

Atlanta Neuro Care PC

  • Neurology Physician
  • Conyers, GA
National Provider Identifier
1720536584
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
ATLANTA NEURO CARE PC
Practice address
1372 Wellbrook Cir NE
Conyers, GA 30012-3872
Phone
(770) 274-3378
Fax
(770) 274-3489
NPI assigned
Sep 21, 2016
Last updated
Apr 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Authorized official

Name
Daniel TesfayeNPI 1023033065
Title
President/Ceo
Phone
(770) 274-3378

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 67614 GA
Neurology Physician 2084N0400X Primary

Addresses

Primary practice location

1372 Wellbrook Cir NE
Conyers, GA 30012-3872

Mailing address

PO Box 542
Conyers, GA 30012-0542
Phone (770) 274-3428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260417002262 GA Part B Supplier - Clinic/Group Practice 8325514219 Receives reassigned benefits from 2 practitioners
Practice locations: Conyers, GA

National Provider Directory

National Provider Directory

Locations

1368 Wellbrook Cir NE
Ste A
Conyers, GA 30012
Phone (770) 274-3378

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775779200000",
    "number": "1720536584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300120542",
            "telephone_number": "770-274-3428",
            "fax_number": "770-274-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1372 WELLBROOK CIR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123872",
            "telephone_number": "770-274-3378",
            "fax_number": "770-274-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA NEURO CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-21",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A",
        "authorized_official_last_name": "TESFAYE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "770-274-3378"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "67614",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.