NPIMap

Organization Active NPI

Georgia Woundcare MD LLC

  • Internal Medicine Physician
  • Cumming, GA
National Provider Identifier
1063231645
Registry record updated Mar 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GEORGIA WOUNDCARE MD LLC
Practice address
1165 Sanders Rd
Cumming, GA 30041-5965
Phone
(210) 379-8553
NPI assigned
Oct 9, 2024
Last updated
Mar 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2025

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

Authorized official

Name
Kishore Rasamallu, MDNPI 1568667863
Title
MD/Owner
Phone
(210) 379-8553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1165 Sanders Rd
Cumming, GA 30041-5965

Mailing address

8000 Avalon Blvd Ste 100
Alpharetta, GA 30009-2469
Phone (210) 379-8553

Other practice location 1

8000 Avalon Blvd Ste 100
Alpharetta, GA 30009-2469
Phone (210) 379-8553

Other practice location 2

1968 Peachtree Rd NW Fl 6
Atlanta, GA 30309-1281
Phone (210) 379-8553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250926002735 GA Part B Supplier - Clinic/Group Practice 7214432475 Receives reassigned benefits from 4 practitioners
Practice locations: Atlanta, GA; Cumming, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743292800000",
    "number": "1063231645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 AVALON BLVD STE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092469",
            "telephone_number": "210-379-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 SANDERS RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415965",
            "telephone_number": "210-379-8553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8000 Avalon Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300092469",
            "country_code": "US",
            "telephone_number": "210-379-8553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1968 Peachtree Rd NW Fl 6",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091281",
            "country_code": "US",
            "telephone_number": "210-379-8553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEORGIA WOUNDCARE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2025-03-30",
        "certification_date": "2025-03-30",
        "status": "A",
        "authorized_official_last_name": "RASAMALLU",
        "authorized_official_first_name": "KISHORE",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "210-379-8553",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.