Prasanna S. Srinagesh MD PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

66648 Issued in GA

Legal business name

PRASANNA S. SRINAGESH MD PC

Practice address

220 Uvalda St
Waycross, GA 31501-4569

Phone

(912) 285-2053

Fax

(912) 283-5520

NPI assigned

Dec 1, 2017

Last updated

Dec 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Prasanna Srinagesh, MDNPI 1104002666

Title

President

Phone

(912) 285-2053

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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.

• Prasanna Sampurna Srinagesh, M.D.

  • Nephrology Physician
  • Waycross, GA
  • NPI 1104002666
  Medicare reassignment Authorized official
• Kristen Brooke Martin, APRN, FNP-C

  • Family Nurse Practitioner
  • Waycross, GA
  • NPI 1922705706
  Medicare reassignment NPD

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512086400000",
    "number": "1154835965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1506",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315021506",
            "telephone_number": "912-285-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 UVALDA ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014569",
            "telephone_number": "912-285-2053",
            "fax_number": "912-283-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRASANNA S. SRINAGESH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-01",
        "last_updated": "2017-12-01",
        "status": "A",
        "authorized_official_last_name": "SRINAGESH",
        "authorized_official_first_name": "PRASANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-285-2053",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "66648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Marie Pittard
• Barbara D Pittman, FNP-C
• Porter Healthcare Solutions LLC
• Shelonda A Porter, M.ED., CCC-SLP
• Deanna Holland Powell, CRNA
• Prasanna Srinagesh MD PC
• Premiere Health & Wellness LLC
• Prime Transport and More LLC
• Charles E Pritchett, LAPC
• Jennifer C Pritchett, D.O.

• Nephrology Physician in Waycross, GA
• Providers in Waycross, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.