Active NPI
Rosmary Duval, PA
- Physician Assistant
- Gainesville, GA
National Provider Identifier
1780136689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9343
- Practice address
- 1315 Jesse Jewell Pkwy NE Ste 201
Gainesville, GA 30501-3822 - Phone
- (770) 219-8765
- NPI assigned
- Oct 27, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.004844RX | OH | |
| Physician Assistant | 363A00000X | 9343 | GA | Primary |
Addresses
Primary practice location
1315 Jesse Jewell Pkwy NE Ste 201
Gainesville, GA 30501-3822
Mailing address
PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420
Other practice location 1
400 Matthew St
Suite 303
Marietta, OH 45750-1644
Phone (740) 373-7828
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rduval103821@nghs.gadirect.net | Direct |
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.004844RX | OH | MD | Physician Assistant |
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.
-
- Family Medicine Physician
- Gainesville, GA
- NPI 1891745212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609977600000",
"number": "1780136689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 742616",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303742616",
"telephone_number": "770-219-8420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 JESSE JEWELL PKWY NE STE 201",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305013822",
"telephone_number": "770-219-8765"
}
],
"practiceLocations": [
{
"address_1": "400 Matthew St",
"address_2": "Suite 303",
"address_purpose": "LOCATION",
"city": "Marietta",
"state": "OH",
"postal_code": "457501644",
"country_code": "US",
"telephone_number": "740-373-7828",
"fax_number": "740-373-5898",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUVAL",
"first_name": "ROSMARY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-27",
"last_updated": "2021-01-07",
"certification_date": "2021-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.004844RX",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "9343",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rduval103821@nghs.gadirect.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1315 Jesse Jewell Pkwy NE Ste 201",
"city": "Gainesville",
"state": "GA",
"country_code": "US",
"postal_code": "305013822",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.