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DR. JUNTIRA LAOTHAVORN M.D.
NPI 1700140712
Psychiatry & Neurology - Psychiatry in Atlanta, GA

Active since June 25, 2012Opted out of Medicare · through Oct 1, 2027
1745 PHOENIX BLVD STE 240, ATLANTA, GA 30349(404) 507-7100 Get Directions Write a Review

NPPES record last updated: December 4, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 4, 2020, Jul 16, 2019 (2 updates tracked since 2019).

About Dr. Juntira Laothavorn M.d. NPPES

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

DR. JUNTIRA LAOTHAVORN M.D. (NPI 1700140712) is an individual psychiatry provider in Atlanta, Georgia, licensed in Georgia (076279) and active in the NPI registry since June 2012. She has opted out of Medicare through October 1, 2027 and remains eligible to order and refer and maintains a secondary practice location in Peoria.

NPPES Registry Identity

NPI1700140712
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameDR. JUNTIRA LAOTHAVORNCredential: M.D.
Location Address1745 PHOENIX BLVD STE 240Atlanta, GA 30349-5534
Mailing Address88 N Avondale Rd # 181Avondale Estates, GA 30002-1323 · (404) 579-4544
Phone(404) 507-7100
Sole ProprietorYes
Enumeration DateJune 25, 2012
Last NPPES UpdateDecember 4, 20202 updates tracked since enumeration
NPPES CertifiedDecember 4, 2020
✔ NPI 1700140712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Licenses✔ Licensed in GA · 076279✔ Licensed in IL · 125061354
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1745 PHOENIX BLVD STE 240, Atlanta, GA 30349
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Secondary Practice Location 1

Location 1221 NE Glen Oak Ave, 7West, Department of Psychiatry and Behavioral MedicinePeoria, IL 61636-0001 · Phone (309) 495-1640

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Juntira Laothavorn M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2017 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2017
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30349 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$172.43 typical visit price
range $56.84 – $172.43
Typical copayment $43.10 (range $14.21 – $43.10)
Most-billed visit code 99205
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LINDA MCKINNON D.O.
Psychiatry & Neurology (Psychiatry)
1745 PHOENIX BLVD STE 240
COLLEGE PARK, GA 30349
Fulton County (404) 507-7100
TIMOTHY LYN HUNSUCKER M.D.
Psychiatry & Neurology (Psychiatry)
1745 PHOENIX BLVD STE 240
COLLEGE PARK, GA 30349
Fulton County (912) 571-9062

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 Juntira Laothavorn's NPI number?

The NPI number for Juntira Laothavorn is 1700140712. It was assigned to this individual provider in the NPPES registry on June 25, 2012.

Where is Juntira Laothavorn located?

Juntira Laothavorn practices at 1745 Phoenix Blvd Ste 240, Atlanta, GA 30349. The listed phone number is (404) 507-7100.

What is Juntira Laothavorn's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Juntira Laothavorn enrolled in Medicare?

No. Juntira Laothavorn has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Juntira Laothavorn was last updated on December 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.