Individual provider Active NPI

Raman S.P Damineni, M.D

  • Internal Medicine Physician
  • Dublin, GA
National Provider Identifier
1033176573
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
043915 Issued in GA
Practice address
1826 Veterans Blvd
Dublin, GA 31021-3620
Phone
(478) 272-1210
Fax
(478) 274-5508
NPI assigned
Apr 27, 2006
Last updated
Jan 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 043915 GA Primary

Addresses

Primary practice location

1826 Veterans Blvd
Dublin, GA 31021-3620

Mailing address

435 Fairfield Dr
Dublin, GA 31021-3895
Phone (478) 275-7456

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
I20220603002427 GA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3476592155

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1033176573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 FAIRFIELD DR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213895",
            "telephone_number": "478-275-7456",
            "fax_number": "478-275-7456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 VETERANS BLVD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213620",
            "telephone_number": "478-272-1210",
            "fax_number": "478-274-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMINENI",
        "first_name": "RAMAN",
        "middle_name": "S.P",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "043915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

Verify at the official NPI Registry.