Bavana Ketha, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

0101275402 Issued in VA

Practice address

5910 Hillandale Dr Ste 203
Lithonia, GA 30058-1878

Phone

(404) 778-3712

NPI assigned

Apr 9, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, GA2 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

Specialty

General Surgery

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Hillandale Hospital Hospital, Lithonia, GA, CCN 110226

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bketha153988@direct.carilionclinic.org

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment Care Compare group NPD
• Carilion Healthcare Corporation

  dba Bridgewater College Student Health Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1447206370
  Medicare reassignment NPD
• Carilion Healthcare Corporation

  • Durable Medical Equipment & Medical Supplies
  • Blacksburg, VA
  • NPI 1407667256
  NPD
• Dekalb Medical Center, Inc.

  dba Dekalb Medical Center at Hillandale

  • General Acute Care Hospital
  • Lithonia, GA
  • NPI 1962403865
  NPD (past)
• Emory Health Care

  • Neurology Physician
  • Atlanta, GA
  • NPI 1376642751
  NPD (past)

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

• Dekalb Medical Center, Inc.

  dba Dekalb Medical Center at Hillandale

  • General Acute Care Hospital
  • Lithonia, GA
  • NPI 1962403865
  Care Compare affiliation

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1164818969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 HILLANDALE DR STE 203",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300581878",
            "telephone_number": "404-778-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 HILLANDALE DR STE 203",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300581878",
            "telephone_number": "404-778-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETHA",
        "first_name": "BAVANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101275402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelda Marie Kemp, RN, MSN, ACNP-BC
• Leola Delores Kemp
• Kendrick Family Practice
• Cynthia Kersee, LMSW
• Kes Inc
• Kevias Health Care LLC (n/a)
• Ki LLC (Lithonia Chiropractic Clinic)
• Qualondra N. Kimber
• Alliyah Symone King
• Jorielle King

• Surgery Physician in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.

Verify at the official NPI Registry.