Individual provider Active NPI

Navinchandra M Ruparelia, MD

  • Gastroenterology Physician
  • Douglasville, GA
National Provider Identifier
1043364862
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
GA26928 Issued in GA
Practice address
4904 Timber Ridge Dr
Suite 202a
Douglasville, GA 30135-1828
Phone
(770) 949-6548
Fax
(770) 949-9561
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X GA26928 GA Primary

Addresses

Primary practice location

4904 Timber Ridge Dr
Suite 202a
Douglasville, GA 30135-1828

Mailing address

4904 Timber Ridge Dr
Suite 202a
Douglasville, GA 30135-1828
Phone (770) 949-6548

Other identifiers 1

IdentifierTypeStateIssuer
00301122AMedicaidGA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
GA26928GAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta West Endoscopy Center LLC PastSince Dec 30, 2008 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1043364862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4904 TIMBER RIDGE DR",
            "address_2": "SUITE 202A",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351828",
            "telephone_number": "770-949-6548",
            "fax_number": "770-949-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4904 TIMBER RIDGE DR",
            "address_2": "SUITE 202A",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351828",
            "telephone_number": "770-949-6548",
            "fax_number": "770-949-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPARELIA",
        "first_name": "NAVINCHANDRA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "GA26928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00301122A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.