Eagles Landing Nephrology and Hypertension LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

EAGLES LANDING NEPHROLOGY AND HYPERTENSION LLC

Practice address

225 Country Club Dr Ste 140
Stockbridge, GA 30281-7392

Phone

(770) 415-5889

Fax

(770) 415-5890

NPI assigned

Feb 4, 2016

Organization subpart

No

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

Authorized official

Name

Chudamani Rao Polkampally, MDNPI 1275620452

Title

Owner

Phone

(770) 415-5889

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chudamani Rao Polkampally, M.D.

  • Nephrology Physician
  • Stockbridge, GA
  • NPI 1275620452
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588204800000",
    "number": "1205294378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 COUNTRY CLUB DR STE 140",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817392",
            "telephone_number": "770-415-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 COUNTRY CLUB DR STE 140",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817392",
            "telephone_number": "770-415-5889",
            "fax_number": "770-415-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES LANDING NEPHROLOGY AND HYPERTENSION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A",
        "authorized_official_last_name": "POLKAMPALLY",
        "authorized_official_first_name": "CHUDAMANI",
        "authorized_official_middle_name": "RAO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-415-5889",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eagle'S Wings Healthcare Services, Inc.
• Eagles Landing Diabetes and Endocrinology
• Eagles Landing Gastroenterology P.C.
• Eagles Landing Medical Center
• Eagles Landing Multi Speciality Group,LLC
• Eagles Landing Pediatric Associates LLC
• Eagles Landing Surgery, P.C.
• James Van Eaton, MD
• Joan Ebersole, OT
• Leon Forrest Echols III, R.PH.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; 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.