Active NPI
Deepti C Challagolla, MD
- Psychiatry Physician
- Gainesville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 90519
- Practice address
- 200 Wisteria Dr
Gainesville, GA 30501-3827 - Phone
- (770) 219-5407
- NPI assigned
- Jul 26, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 90519 | GA | Primary |
| Psychiatry Physician | 2084P0800X | 4301101009 | MI |
Addresses
Primary practice location
200 Wisteria Dr
Gainesville, GA 30501-3827
Mailing address
PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420
Other practice location 1
2751 E Jefferson Ave
Detroit, MI 48207-4180
Phone (313) 993-3434
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dchallagolla130680@nghs.gadirect.net | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Wisteria Dr
Gainesville, GA 30501-3827
Phone (770) 219-5407
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.83 of 100
- Quality
- 80.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.08
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90519 | GA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Georgia Physicians Group Inc | Current | Accepting new patients | |
| Northeast Georgia Medical Center, Inc. | Past | Accepting new patients |
Locations
743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915
597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275
200 Wisteria Dr
Gainesville, GA 30501
Phone (770) 219-3800
Interoperability endpoints
- dchallagolla130680@nghs.gadirect.net
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Gainesville, GA
- NPI 1891745212
-
- General Acute Care Hospital
- Gainesville, GA
- NPI 1427055821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642118400000",
"number": "1124374244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 742616",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303742616",
"telephone_number": "770-219-8420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 WISTERIA DR",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305013827",
"telephone_number": "770-219-5407"
}
],
"practiceLocations": [
{
"address_1": "2751 E Jefferson Ave",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482074180",
"country_code": "US",
"telephone_number": "313-993-3434",
"fax_number": "313-993-3421",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHALLAGOLLA",
"first_name": "DEEPTI",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-26",
"last_updated": "2022-01-14",
"certification_date": "2022-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "90519",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301101009",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dchallagolla130680@nghs.gadirect.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "200 Wisteria Dr",
"city": "Gainesville",
"state": "GA",
"country_code": "US",
"postal_code": "305013827",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.
- 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.