Individual provider Active NPI

Vinoda Makam, M.D

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1114936671
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
053278 Issued in GA
Practice address
5600 Stonewall Tell Rd
Atlanta, GA 30349
Phone
(404) 665-8700
NPI assigned
Aug 5, 2006
Last updated
Aug 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A82887 CA
Psychiatry Physician 2084P0800X 229461 NY
Psychiatry Physician 2084P0800X 053278 GA Primary

Addresses

Primary practice location

5600 Stonewall Tell Rd
Atlanta, GA 30349

Mailing address

5600 Stonewall Tell Rd
Atlanta, GA 30349-2418
Phone (404) 665-8700

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
I20230329000950 GA Practitioner - PsychiatryPractitioner - Podiatry 1850765058 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A82887CAMDPsychiatry Physician
053278GAMDPsychiatry Physician
229461NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Community Service Board CurrentSince Mar 11, 2024 Accepting new patients
Personal Recovery Network LLC Psychiatry CurrentSince Mar 27, 2023 Accepting new patients

Locations

23 Warren St SE
Atlanta, GA 30317
Phone (404) 370-7474

445 Winn Way
Decatur, GA 30030
Phone (404) 294-3745

400 Technology Ct SE
Ste J
Smyrna, GA 30082
Phone (770) 431-2354

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1114936671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 STONEWALL TELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303492418",
            "telephone_number": "404-665-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 STONEWALL TELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30349",
            "telephone_number": "404-665-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKAM",
        "first_name": "VINODA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A82887",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "229461",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "053278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.