Organization Active NPI

Sushrut LLC

  • Family Medicine Physician
  • Locust Grove, GA
National Provider Identifier
1013740414
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUSHRUT LLC
Practice address
3778 Highway 42
Locust Grove, GA 30248-3632
Phone
(678) 610-6649
NPI assigned
Aug 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Authorized official

Name
Nimisha TrivediNPI 1629074299
Title
Owner
Phone
(678) 610-6649

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3778 Highway 42
Locust Grove, GA 30248-3632

Mailing address

3778 Highway 42
Locust Grove, GA 30248-3632
Phone (678) 610-6649

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1013740414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3778 HIGHWAY 42",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302483632",
            "telephone_number": "678-610-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3778 HIGHWAY 42",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302483632",
            "telephone_number": "678-610-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSHRUT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "TRIVEDI",
        "authorized_official_first_name": "NIMISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-610-6649"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust Grove, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.