Individual provider Active NPI

Linda Chacko Kuzhippala, M.D.

  • Obstetrics & Gynecology Physician
  • Roswell, GA
National Provider Identifier
1053725408
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
81462 Issued in GA
Practice address
1015 Mansell Rd
Roswell, GA 30076
Phone
(770) 521-2229
Fax
(770) 521-2231
NPI assigned
Jun 13, 2014
Last updated
Aug 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 81462 GA Primary

Addresses

Primary practice location

1015 Mansell Rd
Roswell, GA 30076

Mailing address

1015 Mansell Rd
Roswell, GA 30076-1507
Phone (770) 521-2229

Other practice location 1

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7000

Other names 1

  • Ms. Linda Thomas Chacko Former name

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
I20220126000642 GA Practitioner - Obstetrics/Gynecology 9032471677 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Women's Health Group, P.C. Obstetrics & Gynecology CurrentSince Mar 7, 2022 Accepting new patients
Atlanta Women's Health Group, P.C. CurrentSince Mar 7, 2022 Accepting new patients
Northside Northpoint OB GYN 2 LLC Obstetrics & Gynecology Past Accepting new patients
Northside Hospital, Inc. Past Accepting new patients
Peachtree Women's Clinic 2 LLC Obstetrics & Gynecology Past Accepting new patients
Northside Hospital, Inc. Past Accepting new patients
Isis Obstetrics & Gynecology, LLC Obstetrics & Gynecology Past Accepting new patients

Locations

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

1800 Northside Forsyth Dr
Ste 250
Cumming, GA 30041
Phone (770) 888-0188

5780 Peachtree Dunwoody Rd
Ste 295
Sandy Springs, GA 30342
Phone (404) 255-0621

5780 Peachtree Dunwoody Rd
Ste 300
Sandy Springs, GA 30342
Phone (404) 252-1137

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1053725408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 MANSELL RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761507",
            "telephone_number": "770-521-2229",
            "fax_number": "770-521-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 MANSELL RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "770-521-2229",
            "fax_number": "770-521-2231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18101 Oakwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244089",
            "country_code": "US",
            "telephone_number": "313-593-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUZHIPPALA",
        "first_name": "LINDA",
        "middle_name": "CHACKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "81462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "CHACKO",
            "middle_name": "THOMAS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.