DR. EVERSLEY DEVON PEMBERTON (NPI# 1528316163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528316163 |
| Entity Type | Individual |
| Full Name | DR. EVERSLEY DEVON PEMBERTON |
| Credential | PH.D. |
| Practice Address |
340 Boulevard Ne 345 Atlanta GA 30312-1273 |
| Mailing Address |
1477 Riverrock Trl Riverdale GA 30296-1169 |
| Practice Telephone | 4046530322 |
| Practice Fax Number | 4046530466 |
| Mailing Telephone | 4048088207 |
| Mailing Fax Number | 6785195762 |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2013-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY003607 | GA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003127613A | 05 |
| Street Address |
340 BOULEVARD NE 345 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30312-1273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225026388 | Patricia A Lloyd | Internal Medicine | 340 Boulevard Ne, Suite 441, Atlanta, GA 30312-1285 | 2005-10-12 |
| 1265895569 | Intown Pediatric Behavioral Wellness LLC | Psychologist | 340 Boulevard Ne, Suite 345, Atlanta, GA 30312-1273 | 2016-04-04 |
| 1780043976 | Arlen Versteeg Phd PC | Psychologist | 340 Boulevard Ne, Ste 345, Atlanta, GA 30312-1273 | 2016-02-16 |
| 1063846509 | Jennifer Lynn Poulos | Psychologist | 340 Boulevard Ne, Suite 345, Atlanta, GA 30312-1273 | 2013-09-01 |
| 1063751014 | Chantay Golson | Counselor | 340 Boulevard Ne, Suite 611, Atlanta, GA 30312-1273 | 2013-02-12 |
| 1669731121 | Larutan Medical | Family Medicine | 340 Boulevard Ne, Suite 318, Atlanta, GA 30312-1273 | 2012-05-03 |
| 1295018760 | John David Olsen | Pharmacist | 340 Boulevard Ne, Ste 143, Atlanta, GA 30312-1273 | 2011-09-21 |
| 1598051054 | The Lung Centers of Georgia | Specialist | 340 Boulevard Ne, Suite 210, Atlanta, GA 30312-1273 | 2011-06-23 |
| 1528399045 | Nison H. Shleifer Md Pa | Internal Medicine | 340 Boulevard Ne, Suite 530, Atlanta, GA 30312-1273 | 2010-01-22 |
| 1013241736 | Lori A Dalcour | Nurse Practitioner | 340 Boulevard Ne, Atlanta, GA 30312-1273 | 2009-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770108516 | Bita Ranjbari | Physician Assistant | 659 Auburn Ave Se, Suite 505, Atlanta, GA 30312 | 2020-06-08 |
| 1609439629 | Adeyinka Edward Adeniyi | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center, 303 Parkway Drive Ne, 4th Floor, Internal Medicine Department, Atlanta, GA 30312 | 2019-04-16 |
| 1003378670 | James Spratt IIi | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Ne, 4th Floor, Wellstar Atlanta Medical Center Department of Orthopaed, Atlanta, GA 30312 | 2019-04-03 |
| 1659833440 | Derrick Edward Wendler | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center Dpt of Orthopaedics, 303 Parkway Drive Ne, 4th Floor, Atlanta, GA 30312 | 2019-04-02 |
| 1336631266 | The Atlanta Small Business Training Consortium, Inc. | Local Education Agency (LEA) | 250 Georgia Ave Se Ste 207a, Atlanta, GA 30312 | 2018-06-06 |
| 1669960134 | Derek Mccranie | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Atlanta, FL 30312 | 2018-04-30 |
| 1336646223 | Amy Ruth Williams | Nurse Practitioner | 383 Ralph Mcgill Blvd Ne Apt D, Atlanta, GA 30312 | 2018-04-09 |
| 1730689183 | Lisa Marie Margavage | Chiropractor | 720 Ralph Mcgill Blvd Ne Unit 210, Atlanta, GA 30312 | 2018-02-12 |
| 1922518836 | Rodney Aldridge | Registered Nurse | 250 Georgia Avenue, Suite 206, Atlanta, GA 30312 | 2017-10-05 |
| 1629599279 | Huda Hashim Elsamani Elsheikh | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Wellstar Atlanta Medical Center, Dept of Graduate Medical Education, Internal Medicine, Atlanta, GA 30312 | 2017-07-05 |
| Find all providers in zip 30312 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403462 | Molly Elizabeth Katherine Mclaren | Psychologist | 1441 Clifton Rd Ne Ste 170, Atlanta, GA 30322-1004 | 2020-10-07 |
| 1255945572 | Kerri Eileen Woodward | Psychologist | 6000 Lake Forrest Dr Ste 103, Atlanta, GA 30328-5902 | 2020-09-03 |
| 1689296980 | Natalie N Watson-singleton | Psychologist | 2124 Cheshire Bridge Rd Ne Apt 4112, Atlanta, GA 30324-5733 | 2020-05-11 |
| 1972123883 | Elizabeth Newton, Psyd and Assoc Inc | Psychologist | 1827 Powers Ferry Rd, Bldg 21, Atlanta, GA 30339 | 2020-04-21 |
| 1669091989 | Juliet Anne Buchwalter | Psychologist | 49 Lenox Pointe Ne Ste A, Atlanta, GA 30324-7426 | 2020-04-16 |
| 1508498395 | Walker Consulting & Psychological Services | Psychologist | 4375 Cobb Pkwy Se Ste 121, Atlanta, GA 30339-5537 | 2020-02-10 |
| 1952958522 | Atlas Psychological Services, LLC | Psychologist | 1100 Spring St Nw Ste 380, Atlanta, GA 30309-2854 | 2019-08-19 |
| 1679047591 | Timothy James Schlairet | Psychologist | 480 John Wesley Dobbs Ave Ne Unit 180, Atlanta, GA 30312-5326 | 2019-01-14 |
| 1578030581 | Marilyn Hazzard Lineberger | Psychologist | 5825 Glenridge Dr Bldg 3, Atlanta, GA 30328-5387 | 2018-10-28 |
| 1952896276 | Chad Irvin Lohman | Psychologist | 3800 Camp Creek Pkwy, Sw, Building 2000, Atlanta, GA 30331-6226 | 2018-06-28 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.