Organization Active NPI

Comprehensive Internal Medicine

  • Internal Medicine Physician
  • Suwanee, GA
National Provider Identifier
1104966050
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMPREHENSIVE INTERNAL MEDICINE
Practice address
3890 Johns Creek Pkwy Ste 120
Suwanee, GA 30024-1285
Phone
(770) 622-9002
Fax
(770) 622-9004
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
Anju Bhushan, MDNPI 1649358961
Title
Owner
Phone
(770) 622-9002

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: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3890 Johns Creek Pkwy Ste 120
Suwanee, GA 30024-1285

Mailing address

3890 Johns Creek Pkwy Ste 120
Suwanee, GA 30024-1285
Phone (770) 622-9002

Other practice location 1

3890 Johns Creek Pkwy
Suite 360
Suwanee, GA 30024-1284
Phone (678) 205-9004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000786 GA Part B Supplier - Clinic/Group Practice 7911993498 Receives reassigned benefits from 14 practitioners
Practice locations: Suwanee, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0990982Comprehensive Internal Medicine PC3890 Johns Creek Parkway, Suite 120, Suwanee, GA 30024Certificate of waiverSep 6, 2027

National Provider Directory

National Provider Directory

Locations

3180 North Point Pkwy
Ste 303
Alpharetta, GA 30005
Phone (678) 205-9004

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1104966050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 JOHNS CREEK PKWY STE 120",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241285",
            "telephone_number": "770-622-9002",
            "fax_number": "770-622-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 JOHNS CREEK PKWY STE 120",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241285",
            "telephone_number": "770-622-9002",
            "fax_number": "770-622-9004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3890 Johns Creek Pkwy",
            "address_2": "Suite 360",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300241284",
            "country_code": "US",
            "telephone_number": "678-205-9004",
            "fax_number": "678-205-9005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMPREHENSIVE INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "BHUSHAN",
        "authorized_official_first_name": "ANJU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-622-9002",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.