Active NPI
Carolyn Neal
- Psychiatry Physician
- Atlanta, GA
National Provider Identifier
1770197584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 14222
- Practice address
- 12 Executive Park Dr NE Ste 142
Atlanta, GA 30329-2206 - Phone
- (404) 727-5157
- NPI assigned
- Aug 31, 2020
- Last updated
- Jun 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 14222 | GA | Primary |
Addresses
Primary practice location
12 Executive Park Dr NE Ste 142
Atlanta, GA 30329-2206
Mailing address
12 Executive Park Dr NE Ste 142
Atlanta, GA 30329-2206
Phone (404) 727-5157
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14222 | GA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656028800000",
"number": "1770197584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 EXECUTIVE PARK DR NE STE 142",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292206",
"telephone_number": "404-727-5157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 EXECUTIVE PARK DR NE STE 142",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292206",
"telephone_number": "404-727-5157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEAL",
"first_name": "CAROLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-31",
"last_updated": "2022-06-24",
"certification_date": "2022-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "14222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.