NPIMap

Individual provider Active NPI

Sitharam Chowdary Nandigam, MD

  • Nephrology Physician
  • Conyers, GA
National Provider Identifier
1003096793
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
063104 Issued in GA
Practice address
1612 Milstead Rd NE
Suite a
Conyers, GA 30012-3738
Phone
(678) 413-3261
Fax
(678) 413-3580
NPI assigned
Nov 9, 2007
Last updated
Dec 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 001831 GA
Nephrology Physician 207RN0300X 063104 GA Primary

Addresses

Primary practice location

1612 Milstead Rd NE
Suite a
Conyers, GA 30012-3738

Mailing address

PO Box 1157
Covington, GA 30015-1157
Phone (678) 413-3261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110623000363 GA Practitioner - Nephrology 3173701059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eastside Premier Nephrology and Hypertension PCGroup PAC ID 5991735037, 3 clinicians

Practice addresses (Care Compare)

1612 Milstead Rd NE
Suite a
Conyers, GA 30012-3738
Phone (678) 413-3261

4570 Memorial Dr
Suite B
Decatur, GA 30032-1444
Phone (678) 413-3261

8425 Mall Pkwy
Stonecrest, GA 30038-6914
Phone (678) 413-3261

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
001831GAMDInternal Medicine Physician
063104GAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usrc Covington LLC PastSince Dec 31, 2023 Accepting new patients

Networks

  • FL HMO
  • AL HMO D-SNP
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • FL HMO D-SNP
  • TN PPO C-SNP
  • AL HMO
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • TN PPO
  • FL HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: snandigam25519@direct.acumenmd.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1003096793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1157",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300151157",
            "telephone_number": "678-413-3261",
            "fax_number": "678-413-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 MILSTEAD RD NE",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123738",
            "telephone_number": "678-413-3261",
            "fax_number": "678-413-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDIGAM",
        "first_name": "SITHARAM",
        "middle_name": "CHOWDARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-09",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "001831",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "063104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.