Individual provider Active NPI

Debadrita Mondal, FNP-BC

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1801439401
Registry record updated May 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
289609 Issued in GA
Practice address
3699 Cascade Rd SW Ste B2
Atlanta, GA 30331-2163
Phone
(404) 691-7006
NPI assigned
Oct 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 289609 GA Primary

Addresses

Primary practice location

3699 Cascade Rd SW Ste B2
Atlanta, GA 30331-2163

Mailing address

3699 Cascade Rd SW Ste B
Atlanta, GA 30331-2164
Phone (404) 691-7006

Other practice location 1

180 Jackson St NE Apt 2506
Atlanta, GA 30312-1373
Phone (408) 896-6832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
289609GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Providers LLC Past Accepting new patients
Piedmont Cardiology of Atlanta, LLC PastSince Jun 22, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1572048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621728000000",
    "number": "1801439401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3699 CASCADE RD SW STE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312164",
            "telephone_number": "404-691-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3699 CASCADE RD SW STE B2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312163",
            "telephone_number": "404-691-7006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Jackson St NE Apt 2506",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303121373",
            "country_code": "US",
            "telephone_number": "408-896-6832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONDAL",
        "first_name": "DEBADRITA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-26",
        "last_updated": "2021-05-23",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "289609",
            "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 May 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.