Individual provider Active NPI

Derek Sloss, MD

  • Psychiatry Physician
  • Villa Rica, GA
National Provider Identifier
1720728363
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
105103 Issued in GA
Practice address
20 Herrell Rd
Villa Rica, GA 30180-5527
Phone
(770) 812-3530
Fax
(770) 812-3531
NPI assigned
Mar 31, 2022
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 105103 GA Primary

Addresses

Primary practice location

20 Herrell Rd
Villa Rica, GA 30180-5527

Mailing address

20 Herrell Rd
Villa Rica, GA 30180-5527
Phone (770) 812-3530

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
I20260622000627 GA Practitioner - Psychiatry 6406238401

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Indiana University School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Greenway Blvd
Carrollton, GA 30117-4338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
TMC-Behavioral Health of West Georgia CurrentSince Jul 20, 2026 Accepting new patients
Tanner Medical Center, Inc. PastSince Jul 20, 2026 Accepting new patients

Locations

100 Professional Pl
Ste 110
Carrollton, GA 30117
Phone (770) 834-0818

101 Quartz Dr
Ste 103A
Villa Rica, GA 30180
Phone (770) 456-3266

Interoperability endpoints

  • Direct secure messaging: dsloss527560@ecommunitydirect.com

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": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1720728363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805527",
            "telephone_number": "770-812-3530",
            "fax_number": "770-812-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805527",
            "telephone_number": "770-812-3530",
            "fax_number": "770-812-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOSS",
        "first_name": "DEREK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "105103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.