Individual provider Active NPI

Vinisha Kalra

  • Physician Assistant
  • Fayetteville, GA
National Provider Identifier
1194581900
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
300 Grandmas LN
Fayetteville, GA 30215-5913
Phone
(762) 822-7861
NPI assigned
Feb 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

300 Grandmas LN
Fayetteville, GA 30215-5913

Mailing address

300 Grandmas LN
Fayetteville, GA 30215-5913
Phone (762) 822-7861

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241029003571 GA Practitioner - Physician Assistant 2365975349 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

501 Redmond Rd NW
Rome, GA 30165-1415
Phone (706) 291-0291

Hospital & facility affiliations

  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Emergency Group, LLC CurrentSince Oct 20, 2025 Accepting new patients
Houston County Emergency Group, LLC CurrentSince Oct 20, 2025 Accepting new patients

Locations

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 4

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 1

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": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1194581900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GRANDMAS LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302155913",
            "telephone_number": "762-822-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GRANDMAS LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302155913",
            "telephone_number": "762-822-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALRA",
        "first_name": "VINISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.