NPIMap

Organization Active NPI

Omni Virtual Health Care Inc

  • Internal Medicine Physician
  • Alpharetta, GA
National Provider Identifier
1093381709
Registry record updated May 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
OMNI VIRTUAL HEALTH CARE INC
Practice address
12895 Keystone CT
Alpharetta, GA 30009-1526
Phone
(210) 379-8553
Fax
(910) 900-1239
NPI assigned
Jun 2, 2021
Last updated
May 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2025

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

Authorized official

Name
Mr. Kishore Rasamallu, MDNPI 1568667863
Title
MD
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 PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12895 Keystone CT
Alpharetta, GA 30009-1526

Mailing address

12895 Keystone CT
Alpharetta, GA 30009-1526
Phone (210) 379-8553

Other practice location 1

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

Other practice location 2

1165 Sanders Rd
Cumming, GA 30041-5965
Phone (210) 379-8553

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210628000175 GA Part B Supplier - Clinic/Group Practice 2769883842 Receives reassigned benefits from 23 practitioners
Practice locations: Alpharetta, GA

National Provider Directory

National Provider Directory

Locations

1968 Peachtree Rd NW
#6
Atlanta, GA 30309

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747526400000",
    "number": "1093381709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12895 KEYSTONE CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091526",
            "telephone_number": "210-379-8553",
            "fax_number": "910-900-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12895 KEYSTONE CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091526",
            "telephone_number": "210-379-8553",
            "fax_number": "910-900-1239"
        }
    ],
    "practiceLocations": [
        {
            "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",
            "fax_number": "910-900-1239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1165 Sanders Rd",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300415965",
            "country_code": "US",
            "telephone_number": "210-379-8553",
            "fax_number": "910-900-1239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OMNI VIRTUAL HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2025-05-18",
        "certification_date": "2025-05-18",
        "status": "A",
        "authorized_official_last_name": "RASAMALLU",
        "authorized_official_first_name": "KISHORE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "210-379-8553",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.