Individual provider Active NPI

Pricha Bunyasaranand, M.D.

  • Specialist
  • Griffin, GA
National Provider Identifier
1124040100
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
14687 Issued in GA
Practice address
656 S 8TH St
Griffin, GA 30224-4214
Phone
(770) 228-2824
Fax
(770) 228-0210
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 14687 GA Primary

Addresses

Primary practice location

656 S 8TH St
Griffin, GA 30224-4214

Mailing address

656 S 8TH St
Griffin, GA 30224-4214
Phone (770) 228-2824

Other names 1

  • Pricha Bunya Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14687GAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124040100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244214",
            "telephone_number": "770-228-2824",
            "fax_number": "770-228-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244214",
            "telephone_number": "770-228-2824",
            "fax_number": "770-228-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNYASARANAND",
        "first_name": "PRICHA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "14687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRICHA",
            "last_name": "BUNYA",
            "credential": "M.D., P.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.