Individual provider Active NPI

Bhagat K. Reddy, MD

  • Interventional Cardiology Physician
  • Ellijay, GA
National Provider Identifier
1144225293
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
055012 Issued in GA
Practice address
14244 Highway 515 N Ste 100
Ellijay, GA 30536-2029
Phone
(404) 996-6596
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 055012 GA
Interventional Cardiology Physician 207RI0011X 055012 GA Primary

Addresses

Primary practice location

14244 Highway 515 N Ste 100
Ellijay, GA 30536-2029

Mailing address

6105 Peachtree Dunwoody Rd Ste A150
Atlanta, GA 30328-5944
Phone (404) 996-6596

Other practice location 1

130 Sparta Hwy
Eatonton, GA 31024-8484
Phone (404) 996-6596

Other practice location 2

88 Clinic Rd
Tate, GA 30177-2588
Phone (404) 996-6596

Other practice location 3

6105 Peachtree Dunwoody Rd
Building a-Ste
Atlanta, GA 30328-5909
Phone (404) 376-1021

Other practice location 4

120 Gordon St
Washington, GA 30673-1602
Phone (404) 996-6596

Other identifiers 2

IdentifierTypeStateIssuer
983326893AMMedicaidGA
983326893FGNOPQRSMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DHAUGUSTA.COCAG.GAA@CCDA.HCADIRECT.NET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040903000500 GA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1850367558 Reassigns benefits to 2 organizations
I20170323000176 IL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 1850367558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Augusta Primary Care Services LLCGroup PAC ID 2466513874, 37 clinicians

Practice addresses (Care Compare)

3624 J Dewey Gray Cir
Suite 301
Augusta, GA 30909-6580
Phone (706) 855-5650

Hospital & facility affiliations

  • Doctors Hospital Hospital, Augusta, GA, CCN 110177
  • Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Services Corporation of Southern Illinois Inc. CurrentSince Mar 7, 2017 Accepting new patients
Augusta Primary Care Services LLC CurrentSince Jul 18, 2017 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Nov 12, 2020 Accepting new patients
Paulding Medical Center, Inc. Past Accepting new patients
American Cardiovascular Centers, P.C. PastSince Aug 3, 2017 Accepting new patients
Piedmont Hospital, Inc Past Accepting new patients
Piedmont Cardiac Disease Specialists, LLC Cardiovascular Disease Past Accepting new patients

Locations

2357 Tobacco Rd
Augusta, GA 30906
Phone (706) 722-3855

3623 J Dewey Gray Cir
Ste 210
Augusta, GA 30909
Phone (706) 651-5780

3624 J Dewey Gray Cir
Ste 301
Augusta, GA 30909
Phone (706) 651-2636

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

120 Gordon St
Washington, GA 30673
Phone (706) 678-1177

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-2200

2 Good Samaritan Way
Ste 220
Mount Vernon, IL 62864
Phone (618) 899-3900

Interoperability endpoints

  • Direct secure messaging: dhaugusta.cocag.gaa@ccda.hcadirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1144225293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6105 PEACHTREE DUNWOODY RD STE A150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285944",
            "telephone_number": "404-996-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14244 HIGHWAY 515 N STE 100",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305362029",
            "telephone_number": "404-996-6596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Sparta Hwy",
            "address_purpose": "LOCATION",
            "city": "Eatonton",
            "state": "GA",
            "postal_code": "310248484",
            "country_code": "US",
            "telephone_number": "404-996-6596",
            "fax_number": "770-557-0535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "88 Clinic Rd",
            "address_purpose": "LOCATION",
            "city": "Tate",
            "state": "GA",
            "postal_code": "301772588",
            "country_code": "US",
            "telephone_number": "404-996-6596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6105 Peachtree Dunwoody Rd",
            "address_2": "BUILDING A-STE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303285909",
            "country_code": "US",
            "telephone_number": "404-376-1021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Gordon St",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "GA",
            "postal_code": "306731602",
            "country_code": "US",
            "telephone_number": "404-996-6596",
            "fax_number": "770-557-0535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDY",
        "first_name": "BHAGAT",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "055012",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "055012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "983326893AM",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "983326893FGNOPQRS",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DHAUGUSTA.COCAG.GAA@CCDA.HCADIRECT.NET",
            "affiliation": "N",
            "address_1": "6105 Peachtree Dunwoody Rd",
            "address_2": "BUILDING A-STE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303285909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ellijay, GA

Sources for this page

Verify at the official NPI Registry.