Individual provider Active NPI

Marie Sanon Deltour, LPN

  • Licensed Practical Nurse
  • Stone Mountain, GA
National Provider Identifier
1841938701
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
083866 Issued in GA
Practice address
1607 Barrington VW
Stone Mountain, GA 30087-1846
Phone
(678) 582-9317
NPI assigned
May 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 083866 GA Primary

Addresses

Primary practice location

1607 Barrington VW
Stone Mountain, GA 30087-1846

Mailing address

1607 Barrington VW
Stone Mountain, GA 30087-1846
Phone (678) 582-9317

Other identifiers 1

IdentifierTypeStateIssuer
003258912AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@royalcareservice.org Royal Care Service, LLC

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
083866GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Care Service, LLC CurrentSince May 29, 2022 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": "1653091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1841938701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 BARRINGTON VW",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871846",
            "telephone_number": "678-582-9317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 BARRINGTON VW",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871846",
            "telephone_number": "678-582-9317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANON DELTOUR",
        "first_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-21",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "083866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003258912A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@royalcareservice.org",
            "affiliation": "Y",
            "affiliationName": "Royal Care Service, LLC",
            "address_1": "1607 Barrington Vw",
            "city": "Stone Mountain",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300871846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2022; 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.