Individual provider Active NPI

Debbie L Byron, DPM

  • Podiatrist
  • Mableton, GA
National Provider Identifier
1902997026
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD000721 Issued in GA
Practice address
252 Tony TRL SE
Mableton, GA 30126-3655
Phone
(678) 662-9406
Fax
(770) 944-9061
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD000721 GA Primary
Primary Podiatric Medicine Podiatrist 213EP1101X POD000721 GA

Addresses

Primary practice location

252 Tony TRL SE
Mableton, GA 30126-3655

Mailing address

1400 Veterans Memorial Hwy SE
Suite 134 #139
Mableton, GA 30126-2945
Phone (678) 662-9406

Other identifiers 2

IdentifierTypeStateIssuer
00630374DMedicaidGA
000630374FMedicaidGA

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
POD000721GAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Village Podiatry Group LLC Podiatrist Past Accepting new patients
Village Podiatry Group, L.L.C. Podiatrist PastSince Jun 1, 2003 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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1902997026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 VETERANS MEMORIAL HWY SE",
            "address_2": "SUITE 134 #139",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262945",
            "telephone_number": "678-662-9406",
            "fax_number": "770-944-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 TONY TRL SE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301263655",
            "telephone_number": "678-662-9406",
            "fax_number": "770-944-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRON",
        "first_name": "DEBBIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD000721",
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "GA",
            "license": "POD000721",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00630374D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000630374F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mableton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.