NPIMap

Individual provider Active NPI

Keerthi Kiran Ponugoti, MD

  • Pulmonary Disease Physician
  • Thomasville, GA
National Provider Identifier
1013228196
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
071394 Issued in GA
Practice address
2705 E Pinetree Blvd Ste C
Thomasville, GA 31792-4875
Phone
(229) 584-5731
Fax
(229) 584-5941
NPI assigned
Jun 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4449 GA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 071394 GA
Pulmonary Disease Physician 207RP1001X 071394 GA Primary
Internal Medicine Physician 207R00000X 071394 GA

Addresses

Primary practice location

2705 E Pinetree Blvd Ste C
Thomasville, GA 31792-4875

Mailing address

2705 E Pinetree Blvd Ste C
Thomasville, GA 31792-4875
Phone (229) 584-5731

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address keerthi.pontugati.p25@direct.archbold.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140827002574 GA Practitioner - Pulmonary DiseasePractitioner - Emergency MedicinePractitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 4284852534 Reassigns benefits to 5 organizations
I20220815003266 VA Practitioner - Internal Medicine 4284852534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Emergency Medicine, Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8000

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606

3340 Paddock Pkwy
Suwanee, GA 30024-9119
Phone (678) 679-6210

3350 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (678) 474-9633

3380 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (678) 474-9633

3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (561) 997-0821

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4449GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Jul 1, 2014 Accepting new patients
Savannah Multispecialty Associates, LLC CurrentSince Aug 16, 2025 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Nov 3, 2022 Accepting new patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Apr 17, 2022 Accepting new patients
Gwinnett Physician Group, LLC Internal Medicine CurrentSince Dec 13, 2024 Accepting new patients
Au Medical Associates Inc CurrentSince Jul 1, 2014 Accepting new patients
Northside Primary Care Professional Services,LLC CurrentSince Nov 3, 2022 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Doctors Hospital of Augusta LLC Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

500 Hospital Dr
Warrenton, VA 20186
Phone (540) 316-5000

Networks

  • FL HMO D-SNP
  • AL HMO D-SNP
  • FL HMO
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • FL HMO C-SNP
  • AL HMO
  • TN PPO C-SNP
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • TN PPO

Organizations & group practices 11

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.

Hospital & facility affiliations 4

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": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1013228196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 E PINETREE BLVD STE C",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924875",
            "telephone_number": "229-584-5731",
            "fax_number": "229-584-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 E PINETREE BLVD STE C",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924875",
            "telephone_number": "229-584-5731",
            "fax_number": "229-584-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONUGOTI",
        "first_name": "KEERTHI",
        "middle_name": "KIRAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "4449",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "071394",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "071394",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "071394",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "keerthi.pontugati.p25@direct.archbold.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2705 E Pinetree Blvd Ste C",
            "city": "Thomasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317924875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.