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MY OBGYN PC
NPI 1669534210
Specialist in Riverdale, GA

Active since December 13, 2006
81 UPPER RIVERDALE RD, SUITE 210, RIVERDALE, GA 30274(770) 996-1200(770) 907-7492 Get Directions Write a Review

NPPES record last updated: November 9, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About My Obgyn Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MY OBGYN PC (NPI 1669534210) is a healthcare organization registered as a specialist in Riverdale, Georgia and active in the NPI registry since December 2006. The organization lists Letitia D Royster, Vice President, as its authorized official.

NPPES Registry Identity

NPI1669534210
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameMY OBGYN PC
Location Address81 UPPER RIVERDALE RD, SUITE 210Riverdale, GA 30274-2627
Mailing AddressPo Box 962380Riverdale, GA 30296-6921 · (770) 996-1200 · Fax (770) 907-2334
Phone(770) 996-1200
Fax(770) 907-7492
Organization SubpartNo
Authorized OfficialLetitia D RoysterVice President · (770) 996-1200
Enumeration DateDecember 13, 2006
Last NPPES UpdateNovember 9, 2012
✔ NPI 1669534210 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in GA · 044077
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
81 UPPER RIVERDALE RD, Riverdale, GA 30274
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Other Identifiers 1

Medicaid300020659AGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

My Obgyn Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to My Obgyn PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Paris Cannon-Mcallister
Obstetrics/Gynecology
NPI 1093276263
81 UPPER RIVERDALE RD SW STE 210
Riverdale, GA 30274
(770) 996-1200
✔ PECOSSame address
Letitia Royster, MD
Obstetrics/Gynecology
NPI 1356425292
81 UPPER RIVERDALE RD SUITE 210
Riverdale, GA 30274
(770) 996-1200
✔ PECOS✔ Accepts MedicareSame address
Clifton Youngblood, MD
Obstetrics/Gynecology
NPI 1275617078
541 HISTORIC HIGHWAY 441 NORTH
Demorest, GA 30535
(706) 839-4000
✔ PECOS✔ Accepts Medicare85 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is My Obgyn PC's NPI number?

The NPI number for My Obgyn PC is 1669534210. It was assigned to this organization in the NPPES registry on December 13, 2006.

Where is My Obgyn PC located?

My Obgyn PC is located at 81 Upper Riverdale Rd Suite 210, Riverdale, GA 30274. The listed phone number is (770) 996-1200.

What is My Obgyn PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is My Obgyn PC enrolled in Medicare?

Yes. My Obgyn PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through My Obgyn PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Obstetrics/Gynecology, reassign their Medicare billing to My Obgyn PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for My Obgyn PC was last updated on November 9, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.