NPIMap

Individual provider Active NPI

Anupama Ravikanth, M.D.

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1184719122
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
048297 Issued in GA
Practice address
140 Vann Street NE
Suite 350
Marietta, GA 30060
Phone
(770) 771-5470
Fax
(770) 771-5471
NPI assigned
Oct 4, 2006
Last updated
Jan 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 048297 GA Primary

Addresses

Primary practice location

140 Vann Street NE
Suite 350
Marietta, GA 30060

Mailing address

140 Vann Street NE
Suite 350
Marietta, GA 30060
Phone (770) 771-5470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050404000855 GA Practitioner - Internal Medicine 7113974981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

4800 Olde Towne Pkwy
Suite 320
Marietta, GA 30068-4357
Phone (770) 442-1911

655 Molly LN
Suite 100
Woodstock, GA 30189-6519
Phone (770) 517-1080

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048297GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC Internal Medicine CurrentSince Jan 13, 2020 Accepting new patients
Southeast Medical Group, P.C. CurrentSince Aug 20, 2022 Accepting new patients
Privia Medical Group of Georgia LLC Internal Medicine CurrentSince Jan 13, 2020 Accepting new patients
Piedmont Medical Care Corporation Internal Medicine Past Accepting new patients

Locations

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

140 Vann St NE
Ste 350
Marietta, GA 30060
Phone (404) 367-9997

4800 Olde Towne Pkwy
Ste 320
Marietta, GA 30068
Phone (678) 341-6370

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Affinity HospiceMarietta, GA, CCN 111762 Hospice Contracted Managing Employee (100%) Aug 13, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • A/B Hospice, LLC

    dba Affinity Hospice

    • Community Based Hospice Care Agency
    • Marietta, GA
    • NPI 1235654039

    Contracted Managing Employee

    CMS ownership

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1184719122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 VANN STREET NE",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-771-5470",
            "fax_number": "770-771-5471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 VANN STREET NE",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-771-5470",
            "fax_number": "770-771-5471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVIKANTH",
        "first_name": "ANUPAMA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "048297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.