Individual provider Active NPI

Akhil Baranwal, MD

  • Hematology & Oncology Physician
  • Douglas, GA
National Provider Identifier
1013916576
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
051294 Issued in GA
Practice address
1105 Lee Ave
Douglas, GA 31533-3409
Phone
(912) 393-5051
Fax
(954) 301-6333
NPI assigned
Jul 18, 2005
Last updated
Jul 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 051294 GA Primary

Addresses

Primary practice location

1105 Lee Ave
Douglas, GA 31533-3409

Mailing address

1105 Lee Ave
Douglas, GA 31533-3409
Phone (912) 393-5051

Other identifiers 1

IdentifierTypeStateIssuer
00964697AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
051294GAMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1013916576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 LEE AVE",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333409",
            "telephone_number": "912-393-5051",
            "fax_number": "954-301-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 LEE AVE",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333409",
            "telephone_number": "912-393-5051",
            "fax_number": "954-301-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARANWAL",
        "first_name": "AKHIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "051294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00964697A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.