Individual provider Active NPI

Dina K. Royal, MD

  • Pediatrics Physician
  • Marietta, GA
National Provider Identifier
1851449649
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2007-01724 Issued in NC
Practice address
2155 Post Oak Tritt Rd
Suite 100
Marietta, GA 30062-8620
Phone
(770) 973-4700
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2007-01724 NC Primary
Pediatrics Physician 208000000X A62559 CA
Pediatrics Physician 208000000X 062765 GA

Addresses

Primary practice location

2155 Post Oak Tritt Rd
Suite 100
Marietta, GA 30062-8620

Mailing address

2155 Post Oak Tritt Rd
Suite 100
Marietta, GA 30062-8620
Phone (770) 973-4700

Other identifiers 3

IdentifierTypeStateIssuer
147VWOtherNCBCBS
00A625590MedicaidCA
5908597MedicaidNC

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A62559CAMDPediatrics Physician
062765GAMDPediatrics Physician
2007-01724NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrics and Adolescent Medicine, PA Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: droyal40385@choa.gadirect.net

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254700800000",
    "number": "1851449649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 POST OAK TRITT RD",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628620",
            "telephone_number": "770-973-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 POST OAK TRITT RD",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628620",
            "telephone_number": "770-973-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYAL",
        "first_name": "DINA",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2007-01724",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A62559",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "062765",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "147VW",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A625590",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908597",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; 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.