Individual provider Active NPI

Aparna V Peethambaram, M.D.

  • Pediatrics Physician
  • Duluth, GA
National Provider Identifier
1053538629
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
59846 Issued in GA
Practice address
1815 Satellite Blvd
#501
Duluth, GA 30097-5237
Phone
(678) 496-2600
Fax
(888) 226-8819
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.089137 OH
Pediatrics Physician 208000000X 59846 GA Primary

Addresses

Primary practice location

1815 Satellite Blvd
#501
Duluth, GA 30097-5237

Mailing address

1815 Satellite Blvd
#501
Duluth, GA 30097-5237
Phone (678) 496-2600

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
59846GAMDPediatrics Physician
35.089137OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Twinkle Pediatrics, LLC Pediatrics PastSince Jan 1, 2023 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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1053538629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 SATELLITE BLVD",
            "address_2": "#501",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300975237",
            "telephone_number": "678-496-2600",
            "fax_number": "888-226-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 SATELLITE BLVD",
            "address_2": "#501",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300975237",
            "telephone_number": "678-496-2600",
            "fax_number": "888-226-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEETHAMBARAM",
        "first_name": "APARNA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.089137",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "59846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.