NPIMap

Organization Active NPI

Brookhaven Aesthestic Institute

Doing business as Reddy Reconstructive Institute

  • Plastic Surgery Physician
  • Brookhaven, GA
National Provider Identifier
1043716392
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
46220 Issued in GA
Legal business name
BROOKHAVEN AESTHESTIC INSTITUTE
Doing business as
Reddy Reconstructive Institute
Practice address
1418 Dresden Dr NE Ste 120
Brookhaven, GA 30319
Phone
(404) 481-5089
Fax
(404) 795-0461
NPI assigned
Apr 4, 2018
Last updated
Feb 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Authorized official

Name
Dr. Puli Pravin Reddy, MDNPI 1487835260
Title
Ceo
Phone
(404) 754-1994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 46220 GA Primary

Addresses

Primary practice location

1418 Dresden Dr NE Ste 120
Brookhaven, GA 30319

Mailing address

3535 Peachtree Rd NE Ste 520-631
Atlanta, GA 30326-3287
Phone (404) 481-5089

Other practice location 1

3535 Peachtree Rd NE Ste 520-631
Atlanta, GA 30326-3287
Phone (404) 754-1994

Other practice location 2

1418 Dresden Dr NE Ste 120
Brookhaven, GA 30319
Phone (404) 481-5089

Other names 1

  • REDDY RECONSTRUCTIVE INSTITUTE Doing business as

National Provider Directory

National Provider Directory

Locations

3535 Peachtree Rd NE
Ste 520631
Atlanta, GA 30326
Phone (404) 754-1994

1418 Dresden Dr NE
Ste 120
Brookhaven, GA 30319
Phone (404) 481-5089

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1043716392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 PEACHTREE RD NE STE 520-631",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303263287",
            "telephone_number": "404-481-5089",
            "fax_number": "404-795-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 DRESDEN DR NE STE 120",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "30319",
            "telephone_number": "404-481-5089",
            "fax_number": "404-795-0461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Peachtree Rd NE Ste 520-631",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303263287",
            "country_code": "US",
            "telephone_number": "404-754-1994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1418 Dresden Dr NE Ste 120",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "30319",
            "country_code": "US",
            "telephone_number": "404-481-5089",
            "fax_number": "404-795-0461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BROOKHAVEN AESTHESTIC INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-04",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "PULI",
        "authorized_official_middle_name": "PRAVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-754-1994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "46220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REDDY RECONSTRUCTIVE INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookhaven, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.