Individual provider Active NPI

Nima Mansouri, MD

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1063155356
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14528 Issued in GA
Practice address
1080 Peachtree St NE Ste 12
Atlanta, GA 30309-6857
Phone
(404) 253-3660
NPI assigned
Apr 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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 14528 GA Primary

Addresses

Primary practice location

1080 Peachtree St NE Ste 12
Atlanta, GA 30309-6857

Mailing address

7035 Sweet Creek Rd
Johns Creek, GA 30097-7833
Phone (404) 606-1647

Other practice location 1

720 Westview Dr SW
Atlanta, GA 30310-1458
Phone (404) 756-1383

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
I20250626001771 GA Practitioner - Internal Medicine 4688186315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

1080 Peachtree St NE
Suite 12
Atlanta, GA 30309-6857
Phone (404) 253-3660

Hospital & facility affiliations

  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14528GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation Internal Medicine CurrentSince Aug 1, 2025 Accepting new patients
Piedmont Providers LLC Internal Medicine PastSince Aug 1, 2025 Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

1080 Peachtree St NE
Ste 12
Atlanta, GA 30309
Phone (404) 253-3660

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1063155356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7035 SWEET CREEK RD",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300977833",
            "telephone_number": "404-606-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 PEACHTREE ST NE STE 12",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303096857",
            "telephone_number": "404-253-3660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Westview Dr SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303101458",
            "country_code": "US",
            "telephone_number": "404-756-1383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOURI",
        "first_name": "NIMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-15",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "14528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.