Individual provider Active NPI

Racquel Puranda, MD

  • Family Medicine Physician
  • Stockbridge, GA
National Provider Identifier
1023740362
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
105473 Issued in GA
Practice address
1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173
Phone
(770) 389-3855
Fax
(770) 474-8078
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 105473 GA Primary

Addresses

Primary practice location

1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173

Mailing address

3333 Riverwood Pkwy SE Ste 250
Atlanta, GA 30339-3304
Phone (770) 914-0116

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250909000430 GA Practitioner - Family Practice 1254711245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Practice addresses (Care Compare)

1240 Eagles Landing Pkwy
Suite 110
Stockbridge, GA 30281-5173
Phone (770) 914-0116

Hospital & facility affiliations

  • Visiting Nurse Health System, Inc Home health agency, Marietta, GA, CCN 117000
  • Centerwell Home Health Home health agency, Kennesaw, GA, CCN 117027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Aylo Health, LLC CurrentSince Aug 1, 2025 Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

3333 Riverwood Pkwy SE
Ste 250
Atlanta, GA 30339
Phone (770) 914-0016

145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855

1240 Eagles Landing Pkwy
Ste 110
Stockbridge, GA 30281
Phone (770) 389-3855

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHHCCA/Endpoint/BHHCCA

Organizations & group practices 5

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 2

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1023740362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RIVERWOOD PKWY SE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393304",
            "telephone_number": "770-914-0116",
            "fax_number": "770-955-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 EAGLES LANDING PKWY STE 110",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815173",
            "telephone_number": "770-389-3855",
            "fax_number": "770-474-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURANDA",
        "first_name": "RACQUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "105473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.