Kalyani Rajeev, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

058657 Issued in GA

Practice address

301 Medical Dr
Suite 504
Lagrange, GA 30240-4144

Phone

(706) 882-5437

NPI assigned

Jul 18, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kalyani Angampally Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krajeev134960@directwellstar.org
• Direct secure messaging: kalyani.rajeev@westgahealth.gadirect.net

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  dba WellStar Internal Medicine Associates of Marietta

  • Internal Medicine Physician
  • Marietta, GA
  • NPI 1912203555
  NPD
• Wellstar Cardiovascular Medicine, LLC

  • Cardiovascular Disease Physician
  • Marietta, GA
  • NPI 1457320319
  NPD (past)
• Moberly Medical Clinics Inc

  dba Moberly Diagnostics

  • Radiology Clinic/Center
  • Moberly, MO
  • NPI 1003226010
  NPD (past)
• Moberly Medical Clinics Inc

  • Multi-Specialty Clinic/Center
  • Moberly, MO
  • NPI 1336135607
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1083613525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MEDICAL DR",
            "address_2": "SUITE 504",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404144",
            "telephone_number": "706-882-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEDICAL DR",
            "address_2": "SUITE 504",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404144",
            "telephone_number": "706-882-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJEEV",
        "first_name": "KALYANI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2002006501",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "058657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416240451H",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krajeev134960@directwellstar.org",
            "affiliation": "N",
            "address_1": "301 Medical Dr",
            "address_2": "Suite 504",
            "city": "LaGrange",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302404144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KALYANI",
            "last_name": "ANGAMPALLY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Eric Ragan II, M.D.
• Awan Khondoker Rahman, D.O.
• Rainey Professional Association
• Jamie B Raisor, ARNP
• Angampally G Rajeev, MD
• Vinayak Ramanath, MD
• Deema Raslan
• Delaina Ray, LPN
• Kathryn Hamlett Ray, APRN
• Reach Learn Grow

• Pediatrics Physician in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.