Venumadhav Reddy Kotla, M.D.

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

79570 Issued in GA

Practice address

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Phone

(770) 297-5700

Fax

(770) 718-1877

NPI assigned

May 27, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN, 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

Hematology/Oncology

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians

University Health System, Inc.Group PAC ID 5294646378, 512 clinicians

Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041
• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
• University Health System, Inc Hospital, Knoxville, TN, CCN 440015
• Stephens County Hospital Hospital, Toccoa, GA, CCN 110032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10383/brand/1/csg/1/fhir/r4

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.

• Northeast Georgia Community Physicians LLC

  dba Longstreet of NGHS

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1881583730
  Medicare reassignment Care Compare group NPD
• The Longstreet Clinic, PC

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1326019977

  Hematology & Oncology

  Medicare reassignment Care Compare group NPD
• University Health System, Inc

  dba UT Internal Medicine Pellissippi

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1790738763
  Medicare reassignment Care Compare group NPD
• Cookeville Regional Medical Center

  dba Cookeville Regional Physicians

  • Hospitalist Physician
  • Cookeville, TN
  • NPI 1023397031

  Hematology & Oncology

  Medicare reassignment NPD
• The Longstreet Clinic PC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1053422428
  NPD
• Cookeville Regional Medical Center

  dba Cookeville Regional Medical Center Inpatient Rehabilitation Center

  • Rehabilitation Hospital Unit
  • Cookeville, TN
  • NPI 1639293483
  NPD
• University Health System Inc

  dba University Thoracic Surgeons

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Knoxville, TN
  • NPI 1306609748
  NPD
• University Health System, Inc

  dba University Cancer Specialist

  • Hematology (Internal Medicine) Physician
  • Knoxville, TN
  • NPI 1548463698
  NPD
• Cookeville Regional Medical Group, Inc

  • Multi-Specialty Clinic/Center
  • Cookeville, TN
  • NPI 1649202102
  NPD (past)

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

• Northeast Georgia Medical Center Habersham LLC

  • General Acute Care Hospital
  • Demorest, GA
  • NPI 1740981430
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation
• Stephens County Hospital Authority

  • Rural Acute Care Hospital
  • Toccoa, GA
  • NPI 1033191267
  Care Compare affiliation
• University Health System, Inc.

  dba University of Tennessee Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1538164090
  Care Compare affiliation

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1194983122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "702-975-7007",
            "fax_number": "770-718-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "770-297-5700",
            "fax_number": "770-718-1877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "743 Spring St NE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013715",
            "country_code": "US",
            "telephone_number": "770-297-5700",
            "fax_number": "770-718-1877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 River Pl",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-297-5700",
            "fax_number": "770-718-1877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 River Pl",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175602",
            "country_code": "US",
            "telephone_number": "770-297-5700",
            "fax_number": "770-718-1877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Blvd",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385014294",
            "country_code": "US",
            "telephone_number": "931-783-2497 x2147",
            "fax_number": "931-783-5666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1640 Falls Rd",
            "address_purpose": "LOCATION",
            "city": "Toccoa",
            "state": "GA",
            "postal_code": "305772411",
            "country_code": "US",
            "telephone_number": "706-886-5353",
            "fax_number": "770-718-1877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 S State St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199013530",
            "country_code": "US",
            "telephone_number": "302-744-7994",
            "fax_number": "302-744-7993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTLA",
        "first_name": "VENUMADHAV",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-27",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "DE",
            "license": "C1-0025235",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "GA",
            "license": "79570",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "44706",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "DE",
            "license": "C1-0025235",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "GA",
            "license": "79570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4236662",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100070430",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1514694",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason L Konzelmann, MD
• Adrianna Shannon Kordek, MD
• Katherine Elisabeth Kostelansky
• Jacob Kostelec, PT, DPT
• Jiten P Kothadia, M.D.
• Natalya Kovalenko, PA
• Michelle Leigh Kowal, AA
• Brenda Jo Kowalske, M.D.
• Svetlana Kozlova, NP
• Lauren M Kraemer, LCSW

• Medical Oncology Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Medical Oncology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.