Individual provider Active NPI

Djenaba Alana Joseph, M.D.

  • Internal Medicine Physician
  • Decatur, GA
National Provider Identifier
1760606693
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301067884 Issued in MI
Practice address
1670 Clairmont Rd
Decatur, GA 30033-4004
Phone
(404) 321-6111
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301067884 MI Primary

Addresses

Primary practice location

1670 Clairmont Rd
Decatur, GA 30033-4004

Mailing address

610 King Sword CT SE
Mableton, GA 30126-6426
Phone (770) 488-3157

Other names 1

  • Djenaba Alana Mitchell Former name

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
I20210811001397 GA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5890199939

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301067884MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Missouri Inc Internal Medicine Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760606693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 KING SWORD CT SE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301266426",
            "telephone_number": "770-488-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "404-321-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "DJENABA",
        "middle_name": "ALANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301067884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DJENABA",
            "last_name": "MITCHELL",
            "middle_name": "ALANA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.